Background
ADHD in Adults
ADHD and motor problems as assessed with the MFNU
ADHD and musculoskeletal pain
Aims of the present study
Methods
Sample
Instruments
MFNU
Name of subtest | Description |
---|---|
01. Dynamic balance-2 legs | Three sideway jumps within marked squares (back and forth). The entire process is repeated three times without stopping. |
02. Dynamic balance-1 leg | Three sideway jumps on one leg within marked squares (back and forth). The entire process is repeated three times without stopping. Both legs are tested. |
03. Diadochokinesis-right | Pronation-supination of one hand with the elbow flexed 90 degrees. The hand is held as an “extension” of the lower arm. The exercise is performed for approximately 15–20 seconds. |
04. Diadochokinesis-left | |
05. Reciprocal coordination | Alternate clenching of one fist while stretching the other in a rhythmic manner for about 15 seconds. Fingers should be almost completely extended after the hand has been clenched. Elbows are at a 90-degree angle with palms facing upwards. |
06. Thumb movement | The tips of the fingers other than the thumb are successively touched with the palmar surface of the tip of the thumb. After each opposition, the subject extends and abducts the thumb. Both hands are tested for approximately 20 seconds. |
07. Walking | Walking with toes alternately pointing outwards (“Chaplin”) and inwards followed by walking on the outer foot rend (Fog’s test) and inner foot rend. |
08. Lifting arm | Lies prone with arms at a 45 degree angle from midline; lifts one arm with the palm of the hand facing the floor. |
09. Lifting leg | Lies prone with the anterior superior iliac spine touching the floor while lifting one stretched leg at a time. |
10. “Flying” | Lies prone, the arm in a 45 degree angle from midline, lifting head, arms and legs. |
11. Palpation | Lies prone. The test leader palpates the back, especially the longissimus and latissimus dorsi. The test leader assesses the mobility of the thorax. |
12. Passive abduction-right hip | Lies supine. Tester holds the subject’s knee and hip in a flexed position. |
13. Passive abduction-left hip | The tester stretches and flexes the leg to elicit relaxation of the hip muscles and abducts the leg. The sides are evaluated separately. |
14. Passive movement-right foot | Lies supine. Tester examines passive movement with dorsal flexion and eversion/plantar flexion of the right and the left feet. |
15. Passive movement-left foot | |
16. Synkinesis | ‘Synkinesis’ is not a separate test but is an item for evaluating the synkinetic movements registered in one or more subtests. When synkinesis is observed, the tester tries to correct it. The synkinesis remaining after correction is scored. |
Score: | Criteria | ||||
---|---|---|---|---|---|
Subtests 01–10 | Subtests 12–15 | Subtest 16 | Subtest 11 | ||
0 | No problems | The task is performed with no problems and little effort | Normal resistance against the movement is registered | Only sporadic synkinetic movements are registered | Normal muscle tone, good mobility in the thorax |
1 | Moderate problems | The task is performed according to instructions but requires a lot of attention and effort or performance quality is below what is expected according to age | Resistance against the movement is registered | Moderate synkinetic movements are registered in one or more subtest | Slightly greater muscle tone, some resistance against movement of the thorax |
2 | Severe problems | The subject cannot perform the task according to the instructions | Strong resistance against the movement is registered | Pronounced synkinetic movements are registered in one or more subtest | High muscle tone, strong resistance against movement of the thorax |
Pain drawing
Numerical pain rating scale
M.I.N.I. Plus
Assessment
Statistical analyses
Approval
Results
Group differences on the MFNU
Motor problem scores of 1 or 2 | ||||||
---|---|---|---|---|---|---|
MFNU subtests
|
ADHD
|
Control
|
p value
|
Mann–Whitney U
| ||
%
|
Median
|
%
|
Median
| |||
01. Dynamic balance-2 legs | 56.0 | 1 |
13.0
| 0 | .004 | 407.5 |
02. Dynamic balance-1 leg | 76.0 | 2 |
37.4
| 0 | .000 | 440.5 |
03. Diadochokinesis-right | 68.0 | 2 |
17.3
| 0 | .000 | 452.5 |
04. Diadochokinesis-left | 80.0 | 2 |
34.7
| 0 | .000 | 459.5 |
05. Reciprocal coordination | 76.0 | 2 |
17.3
| 0 | .000 | 478.5 |
06. Thumb movement | 72.0 | 2 |
26.1
| 0 | .002 | 422.5 |
07. Walking | 56.0 | 1 |
17.4
| 0 | .005 | 404.5 |
08. Lifting the arms | 88.0 | 2 |
39.1
| 0 | .000 | 443.0 |
09. Lifting the legs | 84.0 | 2 |
21.7
| 0 | .000 | 462.0 |
10. “Flying” | 36.0 | 0 |
13.0
| 0 | .102 | 347.5 |
11. Palpation | 96.0 | 1 |
52.2
| 0 | .000 | 473.5 |
12. Passive abduction-r. hip | 84.0 | 2 |
26.1
| 1 | .000 | 458.5 |
13. Passive abduction-l. hip | 84.0 | 2 |
25.7
| 0 | .000 | 464.0 |
14. Passive movement-r. foot | 84.0 | 2 |
17.2
| 0 | .000 | 481.0 |
15. Passive movement-l. foot | 84.0 | 2 |
17.4
| 0 | .000 | 471.0 |
16. Synkinesis | 60.0 | 2 |
26.0
| 0 | .027 | 383.5 |
Group differences in ‘pain location’ and ‘pain level’
Pain location | Group | |
---|---|---|
Control (N = 23) | ADHD (N = 25) | |
No pain | 34.8% | 8.0% |
Localized pain (only in upper body) | 34.8% | 8.0% |
Localized pain (only in lower body) | 13.0% | 4.0% |
Widespread pain | 17.4% | 80.0% |
Total | 100% | 100% |