Fine-Motor Skills and Occupations of Young Adults With Multiple Sclerosis (MS)

PURPOSE: The purpose of this dissertation study was to explore the fine motor (FM) status of YAwMS and determine the role FM skills play in their functional and social occupations. This dissertation study attempted to answer four quantitative questions, one qualitative question and one over-aching question.

QUANTITATIVE: (a) What is the FM status of YAwMS between the ages 18 and 30 years, as measured by the Grooved Peg Board Test (GPBT) and Purdue Peg Board Test (PPBT)? (b) What is the level of perceived satisfaction and performance of occupational tasks that are prevalent in YAwMS, as measured by an adapted Canadian Occupational Performance Measure (COPM)? (c) Is there a difference between the perceived performance and satisfaction of occupations, as measured by the adapted COPM, and the FM skills, as measured by the PPBT and GPBT, of YAwMS? (d) Is there a relationship between the perceived performance and satisfaction of occupations, as measured by the adapted COPM, and the FM skills, as measured by the PPBT and GPBT, of YAwMS?

QUALITATIVE: What are the lived experiences of the occupations and occupational performance associated with the FM skills of MS for young adults?

OVERARCHING: How does the FM status of YAwMS relate to their perceived occupational performance and satisfaction and lived experiences?

DESIGN/METHOD: Forty participants with MS, between the ages of 18 to 30, were recruited to participate in this study. Two standardized measures (PPBT, GPBT) were used to identify possible FM dexterity deficits and one standardized self-report (COPM) was used to measure the perceived satisfaction and performance of occupations for this population. A semi-structured interview was conducted with a subgroup of 18 participants to understand the lived experiences of young adults with MS (YAwMS) and their FM performance during their occupations.

ANALYSIS: Mixed method analysis was an explanatory sequential design that occurred in three stages: 1. quantitative analysis 2. qualitative analysis 3. mixed methods analysis (Creswall & Plano-Clark, 2011). Established norms of the standardized tests were compared to the raw data, then to identify the differences between the perceived satisfaction and performance of occupations of the COPM and fine motor results, an independent two sample t-test was conducted. Also, a Spearman correlation was done to determine a direction of a potential relationship between the PPBT, GPBT subtests and the COPM findings. The qualitative data involved transcription and coding of 18 audio-recorded interviews. A thematic analysis with open coding was completed along with observations of behaviors and field notes taken during the quantitative data collection. Member checking was completed for validity of the results. Merging of the data crossed on a matrix demonstrating the merging of results (Onwuegbuzi & Teddlie, 2003).

RESULTS: Quantitative and qualitative analysis suggested a relationship between FM scores and both perceived performance and satisfaction scores of an adapted performance measure. Sixteen of the 18 participants stated they are unaware of OT services.

CONCLUSION: Young adults with MS perceive difficulties with occupations that are influenced by their FM status. The importance of this proposal shows that unseen FM deficits of YAwMS exist. These results influence OT practice by creating an awareness of a need for OT interventions involving FM performance skills for this population. It is recommended that occupational therapy professionals consider the motor skill needed to perform and complete occupations that specifically require FM skills within their practice of YAwMS. It is important to create awareness of the usefulness of OT practice to multidisciplinary teams.

References

Creswell, J. W. & Plano -Clark, V. L. (2011). Designing and conducting mixed methods research (2nd ed.). Los Angeles, CA: Sage.

Onwuegbuzie, A. J., & Teddlie, C. (2003). A framework for analyzing data in mixed Method research. In A. Tashakkori & C. Teddlie (Eds), Handbook of mixed methods in social & behavioral research. Thousand Oaks, CA; Sage.