THE USE OF UPPER EXTREMITY ANTHROPOMETRICS IN THE CLINICAL-ASSESSMENTOF PATIENTS WITH AMYOTROPHIC-LATERAL-SCLEROSIS

We evaluated the feasibility of using upper extremity anthropometrics to monitor the clinical status of 18 patients with amyotrophic lateral sclerosis (ALS). The bone-free arm muscle area (AMA) was computed usi ng measurement of triceps skinfold thickness and the mid-upper arm cir cumference according to published formulae. The AMA correlated signifi cantly with body mass, isokinetic muscle force generation, cross-secti onal muscle area on computerized tomography scanning, and pulmonary fu nctions including forced vital capacity and maximal voluntary ventilat ion. Serial determinations of AMA demonstrated a decline in 10 of 13 p atients over 6 months. We pilot tested the use of AMA in a clinical tr ial of ciliary neurotrophic factor (CNTF) in the treatment of ALS. The AMA progressively decreased by 13%, 15%, and 30% in ALS patients trea ted with 0 mu g CNTF/kg, 15 mu g CNTF/kg, and 30/mu g CNTF/kg, respect ively, over a 9-month treatment period. We conclude that measurement o f AMA provides a simple, inexpensive method to monitor the progression of muscle atrophy in ALS patients. The technique does not require eff ort on the part of the patient and as such, appears to have potential utility as an outcome measure in clinical drug trials. (C) 1997 John W iley & Sons, Inc.