#ClinicSpeak & #ThinkHand: who know what onychogryphosis means?

How important is to for you to be able to cut your own toenails? #ClinicSpeak #ThinkHand #MSBlog

One of patients with advanced MS who I saw a few week's ago had been having increasing difficulty with mobilising and has had to take to wearing slippers to shuffle between their wheelchair and their bed or toilet. When I got them onto the examination couch and had a look at their feet it was quite clear they had onychogryphosis; in plain English overgrown and neglected toe nails. I had to refer this patient to their local podiatry service and hopefully they will be able to have a regular appointments to have the toenails cut and their feet looked at an maintained in a good condition. I anticipate that when I next see this patient that their walking will be a lot better. 

Poor foot hygiene is a marker of neglect and is associated with disability. 

Image is from NHS choices.

One of  the hand and arm functions that came up as being important to you as part of our #ThinkHand campaign is being able to cut your own toenails. To maintain this function you need good hand function, preserved co-ordination and joint position sensation, reasonable eye sight and enough flexibility to reach your toenails. As I write this post I wonder how much neurological function you need to lose before you are unable to cut your own toe nails? I would be interested to how well the loss of ability to cut your own toenails correlates with your performance on the 9-HPT and EDSS? If you are willing we could do a survey via the blog to answer this question. Who knows we may get a small community publication out of the survey. 

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