Final: MS Flashcards
What are the 10 main clinical manifestations of MS?
- Fatigue
- Sensory disturbances
- Motor impairments
- Bowel and Bladder
- Sexual dysfunction
- Cognitive impairments
- Depression
- Heat intolerance
- Visual disturbances
- Communication limitations
What is another terms for heat intolerance?
Uthoff’s symptom
What are three common motor impairments associated with MS?
Ataxia, intention tremors, spasticity
What is included in functional observation for a pt with MS?
Bed mobility, transitions, transfers, ambulation, wheeled mobility, ADLs
What are some things to consider when taking a history for a pt with MS?
Process of diagnosis, course of disease, current level of function, falls, medications, driving status, environment, social support, specialist involvement, fatigue
What are examples of specific system level impairment questions to ask a pt with MS?
- Heat intolerance
- Vision
- Vertigo, dizziness
- Pain, sensory changes
- Memory or cognition
- Emotional or mood problems
- GI
- Speech or swallowing
- Stiffness and spasms
- Breathing or coughing
What are the three key musculoskeletal assessments for MS?
- AROM/PROM
- Strength and muscular endurance
- Posture
Why is it important to assess both strength and muscular endurance for MS pts?
Fatigability
What does repeated movement testing assess in MS patients?
Fatigability
What neuromuscular assessments should you perform when examining a pt with MS?
Tone, DTR, reflex, CN, cerebellar, postural control, vestibular, dual task
How do you document tone?
Modified Ashworth Scale
How should you assess the cerebellum with a pt with MS?
Metria, diadokokinesia, rebound
What balance related STOMs are indicated for a MS patient?
Berg, Mini-BEST, DGI, Functional reach, Rivermead
What is Lhermitte’s Sign?
MS sign that is the sensation of an electric shock going through the whole body
What types of pain is associated with MS?
Provoking stimuli, headache, hyperpathia, dysesthesias, trigeminal neuralgia, Lhermitte’s
What visual impairments are associated with MS?
Acuity, tracking fields, accommodations
What cardiopulmonary tests and measures should be included when assessing a pt with MS?
Vitals, response to exercise, perceived exertion, respiratory strength
What cognitive components are important to include when examining a pt with MS?
Memory and attention, reasoning and problem solving, stress, coping, sleep, safety awareness
What STOMs can be used to assess cognition in pt’s with MS?
Mini Mental Status, Minimal Examination of Cognitive Function, Beck Depression Inventory
What characteristics are important to consider when assessing fatigue and fatigability?
Frequency, duration and severity, aggravating and easing factors, activity levels and efficacy of rest attempts
What tools can be used to assess fatigue?
1.Modified Fatigue Impact Scale
2. VAS for Fatigue
3. Fatigue Scale for Motor and Cognitive Functions
What does MFIS stand for?
Modified Fatigue Impact Scale
What is the MFIS?
Self report measure of physical, cognitive, and psychosocial function
What is the cutoff on the MFIS to distinguish between fatigued and non-fatigues patietns?
38
What are important factors when examining skin integrity?
Areas of insensitivities, bruising and breakdown, continence, positioning, pressure relieving strategies, safety awareness
What is the gold standard for assessing gait?
Basic gait observation
What gait related STOMs are applicable to MS?
- 12-item MS Walking Scale
- Times 25’ Walk Test
- FGA
- TUG
- 6MWT and 2MWT
- SWOC
- Stair and curb negotiation
What balance examinations are applicable for a pt with MS?
Static and dynamic balance, Rivermead
What does RMI stand for?
Rivermead Mobility Index