{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T09:40:41Z","timestamp":1760348441354,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T00:00:00Z","timestamp":1760227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Authority at Schneider Children\u2019s Medical Center of Israel"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Spinal Muscular Atrophy (SMA) is a genetic neurodegenerative disease characterized by severe muscle weakness and atrophy. Advances in disease-modifying therapies have dramatically changed the natural history of SMA and the outcome measures that are used to assess the clinical response to therapy. Standard assessment methods for SMA are limited in their ability to detect minor changes in fine motor abilities and in patients\u2019 daily functions. The aim of this pilot study was to evaluate the feasibility and preliminary use of the Touchscreen-Assessment Tool (TATOO) alongside standardized tools to detect changes in upper extremity motor function among individuals with SMA receiving nusinersen therapy. Methods: Thirteen individuals with genetically-confirmed SMA, aged 6\u201323 years, eight with SMA type 2, and five with SMA type 3, participated. The patients continued the maintenance dosing of nusinersen during the study period. They were evaluated at the onset of the study, then twice more at intervals at least six months apart. Upper extremity functional assessments were performed via the TATOO and standardized tools: the Hand Grip Dynamometer (HGD), Pinch Dynamometer (PD), Revised Upper Limb Module (RULM), and Nine-Hole Peg Test (NHPT). Results: Significant changes in fine motor function were detected using the TATOO together with other standardized tools. Participants demonstrated notable improvements in hand grip strength and fine motor performance, as measured by the NHPT. The RULM results were not statistically significant for the total study group, particularly in ambulatory patients with SMA type 3. TATOO provided detailed metrics, and revealed enhancements in accuracy and speed across various tasks. However, given the small sample size, the lack of a control group, and the lack of baseline assessment before receiving therapy, these findings should be considered preliminary and exploratory. Conclusions: The findings suggest that the TATOO, alongside traditional assessment tools, offers a sensitive measure of fine motor function changes in patients with SMA. This study highlights the potential of touchscreen-based assessments to address gaps in current outcome measures and emphasizes the need for larger, multicenter studies that will include pre-treatment, baseline, and control data.<\/jats:p>","DOI":"10.3390\/children12101378","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T08:10:31Z","timestamp":1760343031000},"page":"1378","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of Fine Motor Abilities Among Children with Spinal Muscular Atrophy Treated with Nusinersen Using a New Touchscreen Application: A Pilot Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Inbal","family":"Klemm","sequence":"first","affiliation":[{"name":"Department of Occupational Therapy, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2904-8548","authenticated-orcid":false,"given":"Alexandra","family":"Danial-Saad","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 349002, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis R.","family":"Karlin","sequence":"additional","affiliation":[{"name":"Institute of Pediatric Neurology, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rya","family":"Nassar-Yassien","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 349002, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iuliana","family":"Eshel","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hagit","family":"Levine","sequence":"additional","affiliation":[{"name":"Institute of Pulmonology, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamar","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Institute of Pediatric Neurology, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7255-6276","authenticated-orcid":false,"given":"Sharon","family":"Aharoni","sequence":"additional","affiliation":[{"name":"Institute of Pediatric Neurology, Schneider Children\u2019s Medical Center of Israel, Petach Tikva 4920235, Israel"},{"name":"Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.nmd.2017.11.005","article-title":"Diagnosis and management of spinal muscular atrophy: Part 1: Recommendations for diagnosis, rehabilitation, orthopedic and nutritional care","volume":"28","author":"Mercuri","year":"2018","journal-title":"Neuromuscul. 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