Mulitple Sclerosis Flashcards
Multiple sclerosis
Chronic progressive disease
Demyelination occurs in CNS causing neurological signs and symptoms.
Types: Benign Relapse remitting Primary Secondary progressive
Clinical features
Ataxia - wise base poorly coordinated limb placement
Intentional tremor
Dysmetria (over under shooting)
Balance difficulties
Speech problems (slurred, rhythm, flow disrupted)
Dysdiodochokinsea (unable to perform rapid alternating movement)
Fatigue
Pain
Spasms
Spasticity
Outcome measures
12 - item MS Walking scale
MS Impact scale (MSIS-29) 29 questions about the impact MS had on your day to day life in the last two weeks.
Fatigue scale for motor and cognitive functions - 7 questions with a rating of 1 strongly disagree- 7 strongly agree.
MFIS - modified fatigue index scale: focus on how MS related fatigue affects everyday life. High face validity.
MS Qol questionnaire
Generic:
9 hole peg test - (national MS society has high inter-rated reliability and good test re-test reliability. Patients display poor performance 1st tested due to the lack of familiarity.3-4 attempts administration before baseline assessment.
2 min walk test
6 min walk test
Functional reach test
Guidelines
NICE Guidelines - recommend supervised programmes involving moderate progressive resistance training and aerobic exercise suffering mobility problems and/or fatigue.
NICE - consider vestibular rehabilitation for people without fatigue or mobility problems associated with limited standing balance.
NICE - allow people to regain and then maintain strength so they can perform their usual tasks. Consider clients fatigue levels. No exact sets or reps due to this.
Educate on fatigue, may precipitated by heat, overexertion and stress or maybe time of day.
Consider baclofen or gabapentin for spasticity encourage own management.
Scenario
Dressing and dexterity
Fine motor skills
Sit to stand
Walking
Turning
Strength
