# Revised Upper Limb Module (RULM)
Keywords: spinal muscular atrophy, motor function, RULM, upper limb, muscle strength, SMA

> This page provides an overview of the Revised Upper Limb Module (RULM), a clinical assessment tool designed to evaluate upper limb motor function in patients with spinal muscular atrophy (SMA).

## Details
- [Measures of Motor Function](#): Overview of tools used to assess motor function in SMA patients.
- [HINE](#): Details about the Hammersmith Infant Neurological Examination for SMA.
- [HFMSE](#): Information on the Hammersmith Functional Motor Scale Expanded for SMA.
- [WHO Motor Milestones](#): Explanation of motor milestone assessments based on WHO guidelines.
- [CHOP INTEND](#): Overview of the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders.
- [6MWT](#): Description of the 6-Minute Walk Test for evaluating endurance and mobility.
- [ULM](#): Introduction to the Upper Limb Module for assessing arm and hand function.
- [RULM](#): Revised version of the Upper Limb Module addressing ceiling effects, with activities graded from 0 to 2 and a total score of 37.

## RULM Activities
- Bringing hands from lap to table
- Drawing a line along a preprinted path
- Picking up coin/token
- Placing coin/token into cup at various heights
- Reaching and touching coin/token
- Pushing light button
- Tearing paper
- Opening Ziploc container
- Raising cup to mouth
- Lifting weights between circles
- Shoulder abduction and flexion with weights

## References
- Mazzone ES, Mayhew A, Montes J, et al. Revised upper limb module for spinal muscular atrophy: development of a new module. Muscle Nerve. doi:10.1002/mus.25430.

## Reporting Adverse Events
- Ireland: Report via www.hpra.ie.
- UK: Report via https://yellowcard.mhra.gov.uk/ or the Yellow Card app.
- Biogen contact: MedInfoUKI@biogen.com, UK: 0800 008 7401, Ireland: 1800 812 719.