MS and ALS (Big Red Ch. 16-17) Flashcards

1
Q

MS definition

A
  • Chronic, unpredictable, demyelinating disease of the CNS
  • Hardened plaques, inflammation, segmental demyelination, and gliosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Relapsing-Remitting MS

A
  • Clearly defined exacerbations of neurological symptoms followed by periods of partial or complete recovery
  • Most common form at diganosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Primary Progressive MS

A
  • Slow, continuous worsening of symptoms
  • Associated with later age of onset
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Secondary Progressive MS

A
  • Starts out as relapsing-remitting
  • Change of clinical course into steady, progressive, irreversible decline.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Progressive-Relapsing MS

A
  • Steady deterioration from onset with occasional, acute relapses
  • Least common form of MS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PT for MS patients

A
  • Goal is to relieve symptoms, prevent secondary complications, and maintain optimal functioning as long as possible
  • RRMS: avoid aggressive exercise when pt is in exacerbation
  • PPMS, SPMS, and PRMS: start exercise when deterioration has stabilized and no new symptoms appear
  • Exercise within limits of capabilities to slow further deterioration and optimize function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lhermitte’s sign (MS)

A

Intense, sharp, shooting, burning, electric shock-like pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ALS definition

A

Degeneration and loss of motor neurons in spinal cord, brainstem, and brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Avg ALS life expectancy

A

2-5 years from time of diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Risk factors ALS

A
  • Genetic mutation of chromosome 21
  • Neurodegeneration from glutamate toxicity
  • Autoimmune reaction
  • And lots of other stuff….
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PT considerations for ALS

A
  • Overuse weakness does NOT typically occur in muscles with MMT 3/5 or greater
  • Moderate resistance exercise will increase strength in muscles with MMT 3/5 or greater
  • Avoid heavy eccentric exercise
  • Encourage frequent rest breaks in exercise and ADLs to prevent overuse fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Early stage ALS presentation

A
  • Mild to moderate weakness in specific muscle groups
  • Difficulty with ADLs and mobility towards the end of this stage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Early ALS interventions

A
  • Strengthening exercises
  • Endurance exercises
  • AROM, AAROM, stretching
  • Determine potential need for adaptive or assistive devices
  • Ergonomic modifications
  • Energy conservation
  • Education on disease process
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Middle ALS presentation

A
  • Progressive decrease in mobility
  • Wheelchair needed for long distances
  • Increased w/c use towards end of stage
  • Severe to moderate weakness across different muscle groups
  • Progressive decrease in ADL skills
  • Pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Middle ALS interventions

A
  • Support weak muscle groups
  • Modifications to workplace/home
  • Wheelchair prescription
  • Educate caregivers on functional training
  • AROM, AAROM, PROM, stretching
  • Strengthening and endurance at beginning of stage
  • Determine need for pressure relieving devices
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Late ALS presentation

A
  • Wheelchair dependent or bed bound
  • Complete dependence with ADLs
  • Severe weakness of UE, LE, neck, and trunk muscles
  • Dysarthria, dysphagia
  • Respiratory compromise
  • Pain
17
Q

Late ALS interventions

A
  • PROM
  • Pulmonary care
  • Hospital bed and pressure-relieving devices
  • Skin care, hygiene
  • Caregiver education on transfers, positioning, turning, and skin care
  • Mechanical lift
18
Q
A