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Background: The Nine-Hole Peg Test (9HPT) is the golden standard to measure manual dexterity in people with multiple sclerosis (MS). However, administration requires trained personnel and dedicated time during a clinical visit., Objectives: The objective of this study is to validate a smartphone-based test for remote manual dexterity assessment, the ico mpanion Finger Dexterity Test (FDT), to be included into the ico mpanion application., Methods: A total of 65 MS and 81 healthy subjects were tested, and 20 healthy subjects were retested 2 weeks later., Results: The FDT significantly correlated with the 9HPT (dominant: ρ = 0.62, p < 0.001; non-dominant: ρ = 0.52, p < 0.001). MS subjects had significantly higher FDT scores than healthy subjects (dominant: p = 0.015; non-dominant: p = 0.013), which was not the case for the 9HPT. A significant correlation with age (dominant: ρ = 0.46, p < 0.001; non-dominant: ρ = 0.40, p = 0.002), Expanded Disability Status Scale (EDSS, dominant: ρ = 0.36, p = 0.005; non-dominant: ρ = 0.31, p = 0.024), and disease duration for the non-dominant hand (ρ = 0.31, p = 0.016) was observed. There was a good test-retest reliability in healthy subjects (dominant: r = 0.69, p = 0.001; non-dominant: r = 0.87, p < 0.001)., Conclusions: The ico mpanion FDT shows a moderate-to-good concurrent validity and test-retest reliability, differentiates between the MS subjects and healthy controls, and correlates with clinical parameters. This test can be implemented into routine MS care for remote follow-up of manual dexterity., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: D.V.L. is funded by a Fonds Wetenschappelijk Onderzoek (FWO) PhD fellowship (1SD5322N, https://www.fwo.be). S.D. prepares a PhD with icometrix as industrial partner, funded by a personal industrial PhD grant (Baekeland, HBC.2019.2579) appointed by Flanders Innovation and Entrepreneurship. J.B. has nothing to disclose. L.C. is an employee of icometrix. A.D. is an employee of icometrix. A.V.R. has nothing to disclose. A.V.M.-W. has nothing to disclose. M.B.D. has nothing to disclose. M.D. has nothing to disclose. D.S. is an employee and shareholder of icometrix. D.M.S. is an employee of icometrix. J.V.S. has nothing to disclose. G.N. is a minority shareholder of icometrix and a senior clinical research fellow of the FWO Flanders (1805620N, https://www.fwo.be).

Background: Cognitive dysfunction is a frequent manifestation of multiple sclerosis (MS) but its effect on locomotor rehabilitation is unknown., Objective: To study the impact of cognitive impairment on locomotor rehabilitation outcome in people with MS., Methods: We performed a retrospective analysis involving ambulatory patients with MS who were admitted for intensive, inpatient, multidisciplinary rehabilitation at the National Multiple Sclerosis Center of Melsbroek between the years 2012 and 2017. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) was used to determine the cognitive status of subjects as either impaired (COG-) or preserved (COG+). Locomotor outcome was compared between groups with the difference in 6-minute walk test (6MWT) measured at admission and discharge (Δ6MWT). In addition, individual test scores of the BRB-N for attention (Paced Auditory Serial Addition Test 2" and 3"), visuospatial learning/memory (7/24 Spatial Recall Test), verbal learning/memory (Selective Reminding Test) and verbal fluency (Controlled Oral Word Association Test) were correlated to the Δ6MWT., Results: A total of 318 complete and unique records were identified. Both groups showed a significant within-group Δ6MWT during hospitalization (COG+: 47.51 m; COG-: 40.97 m; P  < .01). In contrast, Δ6MWT values were comparable between groups. The odds of achieving a minimal clinical important difference on the 6MWT did not differ significantly between both groups. Only attention/concentration was significantly correlated with Δ6MWT (r = 0.16, P  = .013)., Conclusion: Cognitive impairment based on BRB-N results appears not to impede locomotor rehabilitation in ambulatory patients with MS. Attentional deficits are correlated to the extent of locomotor rehabilitation, suggesting the presence of a subtle effect of cognition., Competing Interests: Declaration of conflicting interests:The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2019.)