MS Assessment Flashcards
What do Myelin Sheaths deteriorate to?
Sclerotic Plaques
(Hardened scars or plaques)
How does the deterioration of Myelin Sheaths affect Action Potentials and Control of Muscle?
Slower and creates an impairment of control for skeletal and smooth muscle
Sclerotic Plaques lead to…
Weakness, Spasticity, Sensory Loss in Balance, Gait, and Functional Activities
Neurons require Energy Metabolism
Oxidative process
What is associated with MS?
Mitochondrial Genetic Variants
Deficient Mitochondrial Metabolism
Can generate more Reactive Oxygen species (ROS) that can wreak havoc in the cell
Key Factors in the induction of demyelination and neurodegeneration
Mitochondrial injury and subsequent energy failure
Mitochondrial Dysfunction in the MS
Respiratory Chain Deficiency
Abnormal Mitochondrial Transport
Abnormal Mitochondrial Gene Expression
Oxidative Damage
Impiarment Energy Production
Exercise on Neurodegenerative Diseases
Contributes to metabolic and mitochondiral reprogramming of tissues via temperature, hypoxia, BP, or pH
Sensory Axons involved in MS
MS is a Sensory-Motor Condition, C-Fibers are not injured and pain is unaltered
Intervention Framework for Posture and Gait Control
Sensory Feedback
Neural Command
Motor Output
Movement Generated
Muscular Performance in MS
Synergistic Patterns
Ataxia Coordination
Flaccid/Weakness
Selective Strength
Speed/Accuracy
Tone in MS
Hypertonicity
DTR
Spasticity
Spasms
Cranial Nerves in MS
CN II, III, IV, and VI
CN VIII
CN IX
CN V
CN VII
Sensory in MS
Proprioception
Somatosensory
Visual Perceptual
Vibrations
CN II Examination
Visual Field loss / Blurred Vision
Presenting symptom of disease
CN III and VI Examination
Abnormality of Horizontal Gaze
Saccades
CN V Examination
Most common facial numbness
CN VIII Examination
Vertigo
Proprioception is gathered from…
Mainly the Muscle Spindle (Length and Velocity) and the GTO (Force Production or Tension)
Conscious knowledge of Movement goes through the…
Dorsal Column Pathway
Proprioception and Vibration
Unconsvious proprioception to the Cerebellum is from…
The muscle spindles and GTO
MS involves which Pathways
Dorsal Column (Conscious)
AND
Muscle Spindles nad GTO (Unconscious)
Weakness in MS
From spinal cord plaques and cortical plaques
Isometric, dynamic strength, and power are all impaired more often in the LE
UE is coordination
How is Muscular Performance affected in MS?
Weakness
Atrophy
Higher proportion of Type 2 Fibers
Reduced rate of force development
Muscular Mechanics in MS
ROM and Muscle Tone
Response TIme
Sensation
Postural Alignment
Postural Reactions
Postural Responses
Bladder Incontinence
Integumentary Exam in MS
Skin breakdown
Pressure sores
Sensory integrity
Cognition Exam in MS
STM
Orientation
Depression
Anxiety
Reductino in processing
Euphoria
Specialty Areas for Examination:
Lhermitte’s Sign
Structure includes the Spinal Cord
Specialty Areas for Examination:
Paresthesias
Brain and Spinal Cord involved
Specialty Areas for Examination:
Chronic Neuropathic Pain
Spinal cord involved
Specialty Areas for Examination:
Paroxysmal Limb Pain
Sudden intense shooting pain in LE’s
MS and Functional Effects
Force Production
Selective Control
Biomechanics
Sensory
Postural Control in Standing
Primary cause for falls in MS is slow conduction speed and impaired central integration
What kind of condition affects Postural Control in MS?
Warm conditions increase the amount of sway
How does Postural Control affect an individual with MS?
Delayed responses to perturbations or changes in COM
Impaired dual task integration
Increased fear of falling
Falls and MS
Happen early, before walking
Tests should be administred
What kind of balance measurements are helpful for MS
Static standing balance measurements are more sensitive and accurate in predicting falls
Spastic Gait in MS
CVA, Head injury, or MS
Ataxic Gait in MS
Head injury or MS
Paretic Gait in MS
Spinal cord injury, Peripheral nerve, or MS
How does gait change over time in patients with MS?
Paretic over time if new lesions occur
Upper Limb Outcome Measures for MS
Boxes and Blocks
Nine Hole Peg Test
Gait Outcome Measures for MS
20m Timed Walk Test
Timed up and gait
Fatigue Outcome Measures for MS
Fatigue Scale for Motor and Cognitive Function
Physical Function Outcome Measures in MS
MS Functional Composite Scale
