MS Part 2

Question 1

What are the primary goals of Disease-Modifying Therapy (DMT) in managing MS?

Answer 1

To reduce the frequency and severity of MS relapses, delay progression of disability, and limit inflammation in the CNS.

Question 2

How does early initiation of DMT benefit patients with MS?

Answer 2

It helps to reduce the severity of the disease, protect quality of life, and prevent further CNS damage.

Question 3

When treating an acute relapse in MS, what are the roles of steroids like Methylprednisolone?

Answer 3

Steroids limit the inflammatory process and shorten the duration of an acute relapse.

Question 4

How should a physical therapist approach the management of spasticity in a patient with MS?

Answer 4

Through stretching, functional training, botox injections, and sometimes surgical interventions.

Question 5

Why is it important to include both exercise and medication in the management of fatigue in MS patients?

Answer 5

Exercise and education are more effective than medication alone, as they help manage fatigue and improve overall physical function.

Question 6

How can visual and auditory cues help patients with MS experiencing ataxia?

Answer 6

They enhance movement awareness, compensating for proprioceptive and sensory deficits.

Question 7

What is the role of plasmapheresis in managing acute MS relapses?

Answer 7

Plasmapheresis is used to enhance recovery from acute relapses by removing harmful immune components from the blood.

Question 8

How can a physical therapist help manage tremors in MS patients?

Answer 8

By using deep brain stimulation, proprioceptive loading, or weighted devices (e.g., wrist cuffs, vests) to improve movement control.

Question 9

What non-pharmacological strategies can help manage MS-related depression?

Answer 9

Complementary therapies like mindfulness, yoga, and regular exercise can help alleviate stress and depression.

Question 10

How can pelvic health physical therapy benefit MS patients with bladder and bowel impairments?

Answer 10

Pelvic health PT can help regulate bladder and bowel function, improving quality of life.

Question 11

What should be the primary focus of PT intervention in patients with MS?

Answer 11

Maximizing function, preserving strength and aerobic capacity, managing spasticity, and educating patients about fatigue management.

Question 12

How should a PT assess fatigue in MS patients during an examination?

Answer 12

By evaluating the frequency, duration, severity of fatigue, and using fatigue scales like the Modified Fatigue Impact Scale.

Question 13

Why is it important to promote static control in MS patients with postural impairments?

Answer 13

Static control improves postural stability in weight-bearing positions, which helps with functional mobility and balance.

Question 14

What tools can be used to evaluate balance and gait in patients with MS?

Answer 14

Modified CTSIB, Berg Balance Scale, Functional Reach Test, and the TUG test are common measures.

Question 15

How should a PT address mobility impairments caused by spasticity in MS patients?

Answer 15

By providing stretching, splinting, and functional training to maintain mobility and prevent further contractures.

Question 16

What are some exercise recommendations for MS patients to prevent overheating during sessions?

Answer 16

Exercise in the morning, use air conditioning, cooling suits, and stay hydrated to avoid fatigue and heat sensitivity.

Question 17

How does proprioceptive loading help improve movement control in patients with ataxia?

Answer 17

By applying light resistance (cuff weights, weighted vest), it increases awareness of limb movement and reduces tremors.

Question 18

What modifications can be made for an MS patient with high fatigue during physical therapy?

Answer 18

Incorporating energy conservation strategies, activity pacing, and rest periods during therapy sessions.

Question 19

Why is it important for patients with MS to avoid exercising to the point of fatigue?

Answer 19

Exercising to fatigue can worsen symptoms like increased weakness and decrease patient motivation.

Question 20

How should a PT assess cognitive impairments in MS patients?

Answer 20

Using tools like MMSE, MOCA, or dual-task assessments to measure cognitive function and attention.

Question 21

What is the purpose of the Modified Ashworth Scale in MS patients?

Answer 21

To assess spasticity levels in the upper and lower limbs and guide spasticity management interventions.

Question 22

How should PTs address vestibular dysfunction in MS patients?

Answer 22

By focusing on dizziness, vertigo, and balance training, including sensory integration techniques.

Question 23

What type of strengthening exercises are recommended for MS patients with spasticity?

Answer 23

Functional training such as sit-stand, bridges, and resistance training with tactile feedback for safety.

Question 24

Why is proprioceptive training essential in MS patients with balance deficits?

Answer 24

It enhances movement coordination and awareness, particularly in patients with sensory or cerebellar ataxia.

Question 25

How can energy conservation strategies be implemented in daily activities for MS patients?

Answer 25

By modifying tasks or the environment, such as using assistive devices like motorized scooters to reduce energy expenditure.

Question 26

What are some heat management strategies to prevent overheating during physical activities for MS patients?

Answer 26

Using cooling devices like cooling vests, neck wraps, and ensuring exercise environments are cool and comfortable.

Question 27

How can caregivers assist in preventing skin injuries in patients with MS who have limited mobility?

Answer 27

By regularly repositioning patients, inspecting skin for redness, and using pressure-relief techniques every 2 hours.

Question 28

What role does assistive technology play in maintaining independence for patients with progressive MS?

Answer 28

Assistive devices like AFOs, walkers, or powered wheelchairs can maintain mobility and help manage fatigue.