MS Management

Question 1

What are Disease-Modifying Therapies (DMT) for MS?

Answer 1

DMTs reduce the frequency and severity of MS relapses and delay the progression of disability.

Question 2

How do DMTs affect the blood-brain barrier (BBB)?

Answer 2

DMTs help heal the BBB, preventing immune cells from entering the CNS and causing inflammation.

Question 3

What are the common treatments for acute relapses?

Answer 3

Steroids like Methylprednisolone and plasmapheresis are common treatments for acute relapses.

Question 4

How is spasticity managed in MS patients?

Answer 4

Spasticity is managed with medications like Baclofen, Botox injections, and stretching exercises.

Question 5

What are the side effects of steroids used for MS relapses?

Answer 5

Steroid side effects include increased blood pressure, fluid retention, hyperglycemia, acne, and insomnia.

Question 6

What medications are used for spasticity management in MS?

Answer 6

Oral medications like Baclofen, Dantrium, and Botox injections are used for spasticity management.

Question 7

How is neuropathic pain treated in MS patients?

Answer 7

Tricyclic antidepressants are helpful for neuropathic pain, and anti-inflammatories can manage pain from spasticity.

Question 8

What is the role of exercise in managing fatigue in MS?

Answer 8

Exercise has been shown to be more effective than medication in managing MS fatigue.

Question 9

How can depression and anxiety be managed in MS patients?

Answer 9

Medications like Prozac, along with complementary therapies like meditation, yoga, and exercise, can help.

Question 10

What bladder and bowel impairments are seen in MS, and how are they managed?

Answer 10

Bladder and bowel dysfunction can be managed with medication and pelvic health physical therapy.

Question 11

What are the primary goals of physical therapy for MS patients?

Answer 11

Maximize function, improve strength and flexibility, manage spasticity, and educate patients on fatigue management.

Question 12

How can stretching and ROM exercises benefit MS patients?

Answer 12

Stretching and ROM exercises help counteract spasticity and maintain joint motion.

Question 13

How do cooling strategies help with thermosensitivity during exercise?

Answer 13

Cooling vests, fans, and cool water immersion can help prevent overheating during exercise.

Question 14

How does physical therapy manage fatigue in MS patients?

Answer 14

PT teaches energy conservation strategies and activity pacing to balance activity with rest.

Question 15

What tools are used to assess fatigue in MS patients?

Answer 15

The Modified Fatigue Impact Scale is commonly used to assess fatigue in MS patients.

Question 16

How are balance and postural impairments managed in MS patients?

Answer 16

PT focuses on postural control exercises, static and dynamic balance, and reactive balance training.

Question 17

What are proprioceptive loading techniques, and how are they used to improve movement control in MS patients?

Answer 17

Proprioceptive loading uses light resistance, like cuff weights, to improve movement control and reduce tremors.

Question 18

How are gait impairments like foot drop and ataxia addressed in MS?

Answer 18

Gait training, proprioceptive loading, and visual cues are used to improve gait impairments like foot drop and ataxia.

Question 19

What intensity levels are recommended for aerobic exercise in MS patients?

Answer 19

Submaximal intensity (60-80% max HR) or using the Borg RPE scale (11-13) is recommended.

Question 20

How can strength training benefit MS patients, and what exercises are recommended?

Answer 20

Strength training improves function; exercises like bird dogs, sit-stands, and resistance band exercises are recommended.

Question 21

Why is it important to balance exercise with rest for MS patients?

Answer 21

Exercising to the point of fatigue can worsen symptoms, so rest periods are essential.

Question 22

How does thermosensitivity affect exercise performance in MS patients?

Answer 22

Thermosensitivity can cause fatigue and worsening symptoms during exercise, requiring cooling strategies.

Question 23

What modifications should be made for exercise in patients with MS experiencing exacerbations?

Answer 23

Exercise should be paused during exacerbations, and restarted once the patient’s condition stabilizes.

Question 24

What is the Borg RPE scale, and how is it used for exercise in MS patients?

Answer 24

The Borg RPE scale helps monitor exercise intensity, aiming for 11-13 early in training and 15-17 as tolerated.

Question 25

What are the benefits of group exercise for MS patients?

Answer 25

Group exercise provides social support and motivation, which can improve adherence and outcomes.

Question 26

What are common coordination and balance impairments in MS patients?

Answer 26

Ataxia, poor foot placement, wide BOS, and coordination deficits are common in MS.

Question 27

How can proprioceptive loading and resistance be used to improve coordination?

Answer 27

Proprioceptive loading with light resistance (e.g., weighted vests or canes) helps improve coordination.

Question 28

What role do weighted vests and canes play in managing ataxia?

Answer 28

Weighted vests and canes reduce ataxic movements and provide stability during ambulation.

Question 29

How can Frenkel exercises help manage ataxia in MS patients?

Answer 29

Frenkel exercises improve coordination by enhancing feedback and using visual cues during movement.

Question 30

What strategies can be used to manage gait impairments in MS patients?

Answer 30

Use of visual/verbal cues, proprioceptive loading, and mirrors/tape lines can help manage gait impairments like foot drop.

Question 31

What home safety modifications can help prevent falls in MS patients?

Answer 31

Remove throw rugs, install grab bars, and ensure adequate lighting to prevent falls.

Question 32

What assistive devices are commonly used to reduce fall risk in MS patients?

Answer 32

AFOs, canes, and large-wheeled walkers with seating help reduce fall risk.

Question 33

How can patients with MS manage energy conservation to prevent falls?

Answer 33

Activity pacing, using mobility aids, and taking rest breaks help conserve energy and prevent falls.