Rehabilitation of Multiple Sclerosis

Question 1

MS

A chronic demyelinating disease that produces lesions in white matter of CNS.   It is one of most common neurological diseases in young adults, — unpredictable with variation in clinical presentation & severity of symptoms from person to person

Answer 1

Multiple Sclerosis

Question 2

Rehab goals in MS:

Answer 2

• Maximize functional independence (compensations)
• Maximize quality of life.
  
  • (progressive disorder)

Question 3

True or false: Due to progressive nature of MS, restoration of abilities & reversal of clinical symptoms may not be realistic expectations

Answer 3

true

Question 4

MS Disease-Specific Mesures:

Answer 4

• Expanded Disability Status Scale for Patients with MS:
  
  • ​​Scores range 0 – 10; 0 = normal neuro function; 10 = death due to MS;
    > 7 = unable to walk
• The Minimum Record of Disability
• MS Functional Composite
• Multiple Sclerosis Quality of Life-54
• MS Quality of Life Inventory
• Functional Examination of MS
• MS Impact Scale

Question 5

MS

How is the Expanded Disability Status Scale for Patients with MS scored?

Answer 5

• ​​Scores range 0 – 10
• 0 = normal neuro function
• 10 = death due to MS
• > 7 = unable to walk

Question 6

Do patients with MS have spasticity?

Answer 6

yes

Question 7

Interventions for spasticity

Answer 7

• stretching
• daily AROM/PROM
• Positioning
• orthotics
• cold application
• inhibitory relaxation techniques
• biofeedback
• functional exercise & weight bearing

Question 8

Sensory Impairments interventions:

Answer 8

• Education about increasing awareness of sensory impairments:
  
  • Teach precautions
  • Skin care
• Augmented Feedback:
  
  • –Brushing/tapping, verbal cues, biofeedback
• Proprioceptive Loading:
  
  • –Exercise, resistance, weights, pool
• Compensatory Strategies
  
  • –Visual compensation

Question 9

Balance/Coordination impairments interventions:

Answer 9

• Balance training activities
• Coordination exercises
• Adaptive equipment
• Extremity weights
• Weighted canes/crutches
• Air splints
• Compensatory techniques

Question 10

Training of locomotion interventions:

Answer 10

• Standing and walking activities
• Weight bearing and weight shifting activities
• Verbal and manual cueing
• Strengthening, stretching, tone reducing and balance activities
• Task-oriented training:
  
  • BWS and treadmill
• Orthotics
• Mobility devices:
  
  • Positioning
  • Wheelchair
  • – Motorized wheelchair

Question 11

can this pt walk?

Expanded Disability Status Scale for Patients with MS score of 6

Answer 11

able to walk

• ​​Scores range 0 – 10;
• 0 = normal neuro function;
• 10 = death due to MS;
• > 7 = unable to walk