Secondary Progressive Multiple Sclerosis - A Case Study

Introduction

Ms. X is a 40 year old female with Secondary Progressive Multiple Sclerosis (SPMS). She came into the Multiple Sclerosis (MS) Clinic at Kingston General Hospital (KGH) as an outpatient to seek progression management and manage her current diagnosis of MS. Ms. X lives with her husband and two adolescent children in a bungalow. Currently, she is equipped with home assisted devices provided by the Occupational Therapist (i.e., raised toilet seat, shower chair, grab bars). Since her diagnosis of MS 10 years ago, Ms. X has complained of episodes of dizziness and fatigue for years and has noticed some changes in her balance and coordination, along with muscle weakness and spasticity. Due to this, she has experienced recent falls and has increasing difficulty in her ambulation. She has also noticed increased pain and reduced sensory deficits in her lower extremities due to her falls. She scored 5.5 on the estimated disability disease steps scale (EDDS). Ms. X has also reported a sensitivity to heat and has often complained that she doesn’t enjoy exercising as it makes her tired and is worried it will exacerbate her symptoms.

Many studies have shown to support Ms. X’s symptoms. Approximately, throughout the course of MS, it is estimated that between 52% and 70% of patients will experience some form of sensory disturbance (reference). A study done by S et al. studied sensory disturbance in people with MS and found that...

Client Characteristics

Ms. X is a 40 year old female with Secondary Progressive Multiple Sclerosis (SPMS) and lives in Kingston, Ontario. She doesn’t have any genetic dispositions as MS is not in her family history. Currently, she is working part-time as an accountant due to her limitations in mobility. Ms. X could benefit from physiotherapy services to help with gait, balance, muscle strength, pain, and a home exercise program. In addition, Physiotherapy services would be able to target functional endurance with day-to-day activities, support independent living, and quality of life in order to reduce her fatigue symptoms.

Examination Findings