Multiple Sclerosis (MS)
Original Editors - Bram Van Laer
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Definition/Description
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Multiple sclerosis (MS) is a complex, chronic, neurological disease, affecting the insulation surrounding nerve fibres (axons) of the central nervous system and the axons. The coating(myelin), protects nerve cells and allows the efficient transmission of electrical impulses along nerve fibres. Because of the progrssive nature and the variation in location of the nervous system result in many clinical presentations. Multiple sclerosis is an autoimmune diseas in wich an immune system dysfunction produces an inflammatory attack directed against the myelin in a process called demyelination but the exact cause of multiple sclerosis is unknown.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Clinically Relevant Anatomy[edit | edit source]
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Epidemiology /Etiology[edit | edit source]
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Characteristics/Clinical Presentation
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The most common symptoms include loss of vision, double vision, stiffness, weakness, imbalance, loss of co-ordination, numbness, pain, problems with bladder and bowel control, fatigue, speech and swallowing disorders, sexual difficulties, emotional changes, intellectual impairment. The type and number of symptoms vary greatly from one individual to another, depending on where the damage occurs in the brain or spinal cord. Multiple sclerosis can for example cause lumbar radiculopathy.The disease is the most common cause of neurological disability affecting people in their productive years, between 15 and 55 years of ageCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. It afflicts women more often than men (ratio of approximately 2:1).Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Overall course and prognosis in multiple sclerosis is most likely to be related to age and the occurrence of the progressive phase of the disease, rather than to relapses or other clinical parameters. Individual prognosis remains hazardous.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
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Medical Management
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Physical Therapy Management
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Different types of teamwork can be applied in MS. The most commonly applied approaches are either multidisciplinary or interdisciplinary models. Physiotherapy is an important aspect of multidisciplinary and interdisciplinary model and will be concerned primarily with sensory-motor disfunction.
The assessment will focus on performing functional activities, posture and movement carefully considering the performance limited by fatigue, pain and others. Analysing these results together with the proper opinion and interest of the person with multiple sclerosis will enable the physiotherapist to set up an individually adjusted programme. This programme needs to be set up so that it is easy to be performed at home, also providing education to self – management approach. Exercises to reduce spasticity, to improve balance and motor coordination are important to minimise the impact of many symptoms on everyday activities.
At a later stage of the disease, physiotherapy interventions focusing on regular stretching, respiratory training and informing the carers about correct postures will prevent further complications. A close collaboration between professional community carers and non professional caregivers at home is a key factor for the successful management of the rehabilitationCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Another study was found that Hippotherapy has a positive effect on balance of persons with multiple sclerosis and has an added benefit of enhancing quality of life.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title While there is no cure for multiple sclerosis, exercise appears to be beneficial at multiple levels, and it may have an important role to play in delaying negative symptoms of the disease.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Also aquatic exercise programs could have a positive effect for persons with progressive multiple sclerosis. Interventions that promote general health, improve energy levels and mental health, and faster social interaction in the presence of physical disability are beneficial for individuals with progressive multiple sclerosis.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Key Research[edit | edit source]
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Resources
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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