Multiple Sclerosis

Question 1

List the 4 types of MS

Answer 1

1. Relapse remitting
2. Primary progressive
3. Secondary progressive
4. Clinically isolated syndrome MS

Question 2

Drug management - drugs are grouped into three types of actions. What are they?

Answer 2

1. Disease modifying drugs
2. Symptom management drugs
3. Acute exacerbation drugs

Question 3

What is the most common MS symptom

Answer 3

fatigue

Question 4

Disease severity is determined by what?

Answer 4

EDSS scores

Question 5

an EDSS score of 0 - 3.5 is indicative of what?

Answer 5

Normal to mild disability

Question 6

an EDSS score of 4 - 5.5 is indicative of what?

Answer 6

Mild to moderate disability

Question 7

an EDSS score of 6 - 7.5 is indicative of what?

Answer 7

Moderate to severe disability

Question 8

an EDSS score of 8 - 9.5 is indicative of what?

Answer 8

Severe disability with restriction to bed or wheelchair

Question 9

Special thing to consider for muscle testing in MS patients

Answer 9

assess fatigability of the muscle

Question 10

List 4 highly recommended measures for MS patients

Answer 10

1. 12 item MS walking scale
2. Multiple Sclerosis Impact Scale (MSIS-29)
3. Modified fatigue impact scale
4. MS QOL Questionnaire

Question 11

Why should general exercise be encouraged in MS

Answer 11

It may be neuroprotective

Question 12

What is MS

Answer 12

An autoimmune demyelination disease affecting nerves of the brain, spinal cord and optic nerves. Secondary effects include an inflammatory response with axonal degeneration and oligodendrite death (CNS myelin sheaths)

Question 13

What cells are responsible for the demyelination of neurons

Answer 13

T cells, B cells and macrophages

Question 14

What gender, age, location and genetic factors increase risk factors for MS

Answer 14

Being female, young, further from the equator, and from European Caucasian descent.

Question 15

What are the drugs for MS

Answer 15

Copaxone - similar makeup as myelin sheaths, increases protection of myelin
Endogenous Interferon - prevent autoimmune T cells from proliferating and passing BBB
Tysabri - prevents auto reactive T cell from adhering to adhesion molecule and entering BBB

Question 16

Typical signs and symptoms of MS

Answer 16

Fatigue
Heat intolerance 
Motor symptoms 
Weakness
Ataxia 
Spasticity
Pain 
Sensation changes
Cognitive changes
Bladder and bowel disturbance
Dizziness
Visual disturbance
Swallow and speech disturbance
Sexuality and intimacy disturbances

Question 17

What is the order of exercise management principles in early stage neurological disorders

Answer 17

1. Preventative
2. Restorative
3. Compensatory

Question 18

What is the order of exercise management principles in middle and late stage neurological disorders

Answer 18

1. Compensatory
2. Prevention
3. Restorative