Multiple Sclerosis Flashcards
What systems are involved in MS?
Neurological, immune
When MS strike?
20 to 40 yo
Is MS curable?
No but meds can help:
- Speed recovery from attacks
- Modify the course of the disease and symptoms
Can you have Multiple Sclerosis and be an athlete?
- yes
- Kayla runs track and field
MS - What is it ?
Chronic, progressive disease that leads to increasing disability in most individuals
MS - Multiple means?
Many scattered areas of the brain and spinal cord are affected
MS - Sclerosis means?
hardened tissue in damaged areas
MS - Process ?
Immune system attacks the myelin sheath causing communication problems between the brain and the rest of the body
MS - Incidence
- 55 000 to 75 000 people in CAN
- More women than men
- Cost more than 1 billion / year to canadian economy
MS - Incidence (number of people) in CAN
- 55 000 to 75 000 people in CAN
- 166 people per 100 000
- More women than men
MS - Incidence (age)
- Most common central nervous system disease in young adult
- Avg age of clinical onset 30-33
- Avg age of diagnosis 37
MS - why is there a delay before diagnosis?
- Symptoms comes and go
- Ms get mixed up w/ other conditions
- Symptoms vary from person to person
MS - Incidence (life expectancy)
- 1936, 8% survive beyond 20 years after onset of illness
- Now, average population life-expectancy - 7 years
Because of better treatment and better knowledge of the illness
MS - Incidence (cost)
- Cost more than 1 billion / year to canadian economy
MS - Causes
- unknown
- considered au autoimmune disease in which the immune system attacks the tissue by accident
MS - T-cell and Monocytes
Destroy the myelin sheath
MS - Risk factors (8)
- Age
- Sex
- Family history
- Certain infections
- Climate
- Certain autoimmune diseases
- Smoking
- Race
MS - incidence per population (inuit)
19 per 100 000
MS - incidence per population (scottish)
- 200 per 100 000
- Highest rate
MS - ratio of white to non-white people
2:1
MS - Symptoms
Differ greatly from each person and over the course of the disease depending on type and location
MS - types of lesion locations (5)
- Optic nerve lesion
- Brain stem lesion
- Cerebellum and cerebrum lesion
- Motor nerve tract lesion
- Sensory nerve tract lesion
MS - Symptoms associated to optic nerve lesion
Blurred vision
MS - Symptoms associated to brain stem lesion
Dizziness and double vision
MS - Symptoms associated to Cerebellum and cerebrum lesion
Balance and speech problems, uncoordinated mvt and tremors
MS - Symptoms associated to motor nerve tract lesion
Muscle weakness, spasticity paralysis, bladder and bowel impairments
MS - Symptoms associated to sensory nerve tract lesion
Altered sensation, numbness, prickling, burning sensations
MS - other symptoms
- Fatigue (78% of all patient)
- Tremor, lack of coordination or unsteady gate
MS walking pattern
Lack of opposition of arms and legs
Course of MS - best scenario
Exacerbation -> Remission
Course of MS - Luckiest scenario
Exacerbation -> Myelin becomes inflames -> No scar formation -> Complete recovery -> No loss of function
Course of MS - Worst scenario for more severe crisis
Exacerbation -> Myelin becomes inflames -> Scar formation -> Permanent myelin damage-> Loss of function
Course of MS - Synonym of exacerbation
- Flare-up
- Attack
- Relapse
Course of MS - What does therapy help with ?
- Decrease severity
- Decrease frequence of relapse
MS - Classification based on
- Rate of disease progression
- Frequency of flare-ups
MS - Types (4)
- Relapsing / Remitting MS (RRMS)
- Secondary progressive MS (SPMS)
- Primary progressive MS (PPMS)
- Progressive-relapsing MS (PRMS)
Type of MS - Relapsing / Remitting MS (RRMS)
- Most common type
- Unpredictable but define by relapses where new symptoms appear or existing one worsen.
- Between relapse, recovery is complete or nearly complete
- Meds can help
Type of MS - Secondary progressive MS (SPMS)
- Over time, less apparent distinct relapses and remission
- Disease begins to progress steadily
- Half of people with RRMS, worsen 10-20 yrs after diagnosis = increase level of disability
- Meds can help
Type of MS - Primary progressive MS (PPMS)
- Slow accumulation of disability without defined relapse
- Stabilize for periods of time and minor temporary improvement
- No periods of remission
- 10 % of people w/ MS
- Meds cannot help
Type of MS- Progressive-relapsing MS (PRMS)
- Rarest type = only 5% of MS cases
- Experience relapses with or without recovery
- Steadily worsening disease from the beginning
- Meds can help
MS and exercise - Guidelines
- Reduce fatigue
- Improve mobility
- Enhance elements of health-related quality of life
MS and exercise - Who guidelines for?
Adults with mild to moderate MS resulting from relapsing remitting or progressive forms of MS
MS and exercise - Is KCEP qualified to train MS client
Yes
MS and exercise - Aerobic activity
- 2x / week
- At least 30 min during each session
- Moderate intensity (5-6 / 10)
- General rule, you can talk but not sing a song during moderate intensity activity
MS and exercise - Aerobic activity types of exercises
- Arm cycling
- Walking, leg cycling
- Elliptical training
MS and exercise - Strength training activity
- 2x / week
- Work up to 2 sets of 10-15
- Pick a resistance heavy enough that you can barely finish 10-15 reps of last set
MS and exercise - Strength training activity types of exercises
- Weight machines
- Free weight
- Cable pulleys
MS and exercise - Other types of exercises
- Elastics resistance bands
- Aquatic exercise
MS vs Exercise - Considerations
- Lower level of fitness (cardiovascular, muscular strength and endurance)
- Decrease balance
- Fatigue
- Heat intolerance
- Depression
- Exercise doesn’t trigger period of exacerbation if done properly
MS vs Exercise - Effects of exercise
- Increase aerobic capacity
- Increase muscular strength and endurance
- Increase quality of life
- Increase independence in ADL
