Lecture 24 Flashcards
Multiple Sclerosis
demylination of neurons running in CNS
mylen sheath, affecting conduction velocities
become slower and slower, affecting motor and sensory processes
What is the most common type of MS
relapsing remitting MS, where there are peaks of responses as they relapse with more symptoms, then remits for a while
___ are frequently reported with MS
balance impairment and falls
Balance impairment in progressive MS ____ than in relapsing remitting forms
greater
Gait and balance impairment can be detected ____, even in the _____
in the early stages of the disease, absence of clinical signs of pyramidal dysfunction
Compared to healthy control subjects, MS patients have ____
larger amplitude sway (eyes open and closed)
comparing no falls to falls in patients with MS, __
there is a greater amplitude sway in patients with a history of falls
As patients progress to higher levels of symptoms (MS), ____
see larger increases in balance deficits with larger amplitudes of sway and velocity of sway
T/F APAs are changed significantly in patients with MS
true
APAs in patients with MS are ___
significantly delayed in onset and smaller in amplitude
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Cameron et. al., 2008 reviewed postural reactions influenced by MS. What did they see?
significantly delayed onset of the balance correcting response
significant decrease in balance correcting activity amplitude
balance correcting responses are/are not cortically driven?
are not
balance correcting responses are likely driven by ___
brainstem structures that react to sudden onset of purturbation
Compensatory responses influenced by MS are ____
significantly delayed onset of muscle activity
Behaviour of step response in patients with MS
respond with an APA prior to step response
not seen in healthy subjects therefore step onset is significantly delayed
much more forward COM displacement as a result
cognitive-postural interfererence in MS
conducted multiple dual task tests with varying difficulty
large disruptions in postural control
more attentional demand, dont use a postural first strategy and balance is affected
what is CIDP
chronic inflammatory demyelinating polyneuropathy
autoimmune, muscle weakness and loss of sensation in arms and legs (distal and proximal)
loss of balance is most bothersome symptom for them
what is used for CIDP treatment
intravenous immunoglobulin
improves strength and sensory function
___ COP sway parameters in CIDP patients compared to healthy controls
increased
_____ COp sway parameters were found to ____ with IVIg treatment
increased, significantly improve
however, treatment is very expensive so crucial to understand benefits
while examining apas via gait initiation in CIDP patients_____
apas are significantly smaller, and longer in duration
results in slower and smaller initial steps with CIDP
see that the APA initially goes to stance leg, (incorrect), and then has to shift quickly to swing leg
