Multiple Sclerosis (MS): Difference between revisions

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<div class="noeditbox">Welcome to [[Pathophysiology of Complex Patient Problems|PT 635 Pathophysiology of Complex Patient Problems]] This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div><div class="editorbox">
'''Original Editors ''' - [[User:Bram Van Laer|Bram Van Laer]]  
'''Original Editors '''- [[Pathophysiology of Complex Patient Problems|Students from Bellarmine University's&nbsp;Pathophysiology of Complex Patient Problems project.]]  


'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}  &nbsp;  
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}  &nbsp;
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== Definition/Description<br> ==
== Definition/Description  ==


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.<ref name="1">European-wide recommendations on rehabilitation for people affected by multiple sclerosis; EMSP &amp;amp;amp; R.I.MS; october 2004(level D)</ref>  
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== Clinically Relevant Anatomy ==
== Prevalence ==


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== Epidemiology /Etiology ==
== Characteristics/Clinical Presentation ==


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== Characteristics/Clinical Presentation<br> ==
== Associated Co-morbidities ==


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 [http://www.physio-pedia.com/index.php5?title=Lumbar_Radiculopathy lumbar radiculopathy].The disease is the most common cause of neurological disability affecting people in their productive years, between 15 and 55 years of age<ref name="1" />.&nbsp;It afflicts women more often than men (ratio of approximately 2:1).<ref name="2">Sean Horton, Dany J. MacDonald, Karl Erickson; MS, exercise, and the potential for older adults.fckLREur Rev Aging Phys Act. 2010; 7:49–57 (level A1)</ref>&nbsp;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.<ref name="3">Sandra Vukusica and Christian Confavreux.; Natural history of multiple sclerosis: risk factors and prognostic indicators.; Current Opinion in Neurology. 2007; 20:269–274(level A1)</ref>  
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== Differential Diagnosis ==
== Medications ==


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== Diagnostic Procedures ==
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== Outcome Measures ==
== Etiology/Causes ==


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== Systemic Involvement ==


== Medical Management <br>  ==
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== Medical Management (current best evidence)  ==


== Physical Therapy Management <br>  ==
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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.
== Physical Therapy Management (current best evidence)  ==


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.
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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 rehabilitation<ref name="1" />.
== Alternative/Holistic Management (current best evidence)  ==


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.<ref name="4">C. Bronson, K. Brewerton, J. Ong.; Does hippotherapy improve balance in persons with multiple sclerosis: a systematic review.; Eur J Phys Rehabil Med. 2010 ; 46(3):347–53(level A1)</ref>&nbsp;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.<ref name="2" />
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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.<ref name="5">G. Roehrs, Gregory M. Karst; Effects of an Aquatics Exercise Program on Quality of Life Measures for Individuals with Progressive Multiple Sclerosis; Journal of Neurological Physical Therapy. 2004; 28, 63-71(level C)</ref><br>
== Differential Diagnosis  ==


== Key Research  ==
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== Resources <br> ==
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== Clinical Bottom Line  ==
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
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see [[Adding References|adding references tutorial]].  
see [[Adding References|adding references tutorial]].  


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[[Category:Vrije_Universiteit_Brussel_Project]][[Category:Neurology]]
[[Category:Bellarmine_Student_Project]]&nbsp;

Revision as of 19:05, 5 February 2014

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.

Top Contributors - Elizabeth Niebuhr, Vidya Acharya, Sarah Demarest, Laura Ritchie, Nikhil Benhur Abburi, Garima Gedamkar, Kim Jackson, Bram Van Laer, Lucinda hampton, Admin, Eta Frida, Rachael Lowe, Magdalena Hytros, Naomi O'Reilly, WikiSysop, Memoona Awan, Venus Pagare, Sheik Abdul Khadir, 127.0.0.1, Elaine Lonnemann, Wendy Walker, Evan Thomas, Rishika Babburu, Elien Lebuf, Tarina van der Stockt, Rucha Gadgil, Jaroslaw Pospiech and Jess Bell  

Definition/Description[edit | edit source]

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Prevalence[edit | edit source]

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Characteristics/Clinical Presentation[edit | edit source]

add text here

Associated Co-morbidities[edit | edit source]

add text here

Medications[edit | edit source]

add text here

Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]

add text here

Etiology/Causes[edit | edit source]

add text here

Systemic Involvement[edit | edit source]

add text here

Medical Management (current best evidence)[edit | edit source]

add text here

Physical Therapy Management (current best evidence)[edit | edit source]

add text here

Alternative/Holistic Management (current best evidence)[edit | edit source]

add text here

Differential Diagnosis[edit | edit source]

add text here

Case Reports/ Case Studies[edit | edit source]

add links to case studies here (case studies should be added on new pages using the case study template)

Resources
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add appropriate resources here

Recent Related Research (from Pubmed)[edit | edit source]

see tutorial on Adding PubMed Feed

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References[edit | edit source]

see adding references tutorial.

 

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