MS Interventions Flashcards
What are two modifiable RF
SMOKING and ex
2 things MS pts should be educated on in regard to relapse and protection
Immunizations and UTI (common cause of relapse)
5 triggers to avoid
-child birth
-stress/heat
-decreased vit D
-lack of sleep
-over exertion
What is one disease modifying therapy
Interferon beta - decrease inflam, made by WBC
3 essential concepts for motor learning
-task/goal
-environment
-individual
Why is it important to start ex soon after dx
Prevent secondary disuse patterns (ex. Mus weakness —> osteoporosis)
What is the ex recommendation from MS Society
150 min/wk or more
30 min 3x/wk for 3 m’s
MS Society’s take on aerobic ex benefits
-increase hippocampal vol and mem
AMJ Physical Med rehab ex recommendation mild to mod MS
2-3x/wk aerobic and resist, mod intensity
What group activity had evidence? What did it improve?
Chair yoga
Fatigue and flexibility
What causes MS related fatigue
Mitochondrial damage
What defines chronic persistent fatigue
> 6 wk’s, 50% of time
What 3 symptoms does increased core temp affect
Fatigue, wk, visual probs
4 secondary causes of fatigue
Med, stress, weather, depression
Pt edu strats for fatigue
Stop smoking
Encourage midday nap
Decrease fat diet
Drink cool liquid
What structure does motor learning enhance
Oligodendrocytes
What are two major balance deficits/causes
Slow conduction of proprioception
Impaired central integration
Proprioception and vestibular deficits cause what major balance impairment (also %)
75% sway disturbances in quiet stance
3 major balance exercises
Sensory based (prop and vestib acts)
Whole body vib
Axial loading with weighted vest
Two strength focuses
Ecc and cortical excitability
What 3 structures of brain involved with dual tasking
Cerebellum, prefrontal cortex, parietal lobe
4 signs that AD may be needed
-decreased energy
-decreased ankle strat
-abnorm balance loss
-loss proprio
Best AD
Trekking poles
4 factors that increase spasticity
-pressure ulcers (d/t pain)
-bowel and bladder dysfxn
-infection
-pain
First and second type of med for spasticity
-oral baclofen
-gabapentin
3 types of spasticity? Describe each
Generalized: all over body
Regional: mus and adjacent
Focal: one mus
What are the tx for each type of spasticity
Generalized: oral meds
Regional: intrathecal baclofen
Focal: botulinum toxin injection
TENS setting that is beneficial for spasticity
100 Hz, 0.3 ms, for 20 min/day for 4 wks
How is Galileo beneficial for spasticity
-provides sensory info
-resets spinal reflex (mus spindle)
What does muscle spindle respond to
Length and velocity
What does a quick stretch lead to
Stx reflex spindle and prolonged clonus
What does prolong affect muscle spindle
Habituates and decreases signaling
What is BDNF? What are two benefits/functions?
Brain derived neurotrophic factor (BDNF)
Support neuro genesis and increase synaptic connections
