Multiple Sclerosis

Question 1

What systems are involved in MS?

Answer 1

Neurological, immune

Question 2

When MS strike?

Answer 2

20 to 40 yo

Question 3

Is MS curable?

Answer 3

No but meds can help:

• Speed recovery from attacks
• Modify the course of the disease and symptoms

Question 4

Can you have Multiple Sclerosis and be an athlete?

Answer 4

• yes

- Kayla runs track and field

Question 5

MS - What is it ?

Answer 5

Chronic, progressive disease that leads to increasing disability in most individuals

Question 6

MS - Multiple means?

Answer 6

Many scattered areas of the brain and spinal cord are affected

Question 7

MS - Sclerosis means?

Answer 7

hardened tissue in damaged areas

Question 8

MS - Process ?

Answer 8

Immune system attacks the myelin sheath causing communication problems between the brain and the rest of the body

Question 9

MS - Incidence

Answer 9

• 55 000 to 75 000 people in CAN
• More women than men
• Cost more than 1 billion / year to canadian economy

Question 10

MS - Incidence (number of people) in CAN

Answer 10

• 55 000 to 75 000 people in CAN
• 166 people per 100 000
• More women than men

Question 11

MS - Incidence (age)

Answer 11

• Most common central nervous system disease in young adult
• Avg age of clinical onset 30-33
• Avg age of diagnosis 37

Question 12

MS - why is there a delay before diagnosis?

Answer 12

• Symptoms comes and go
• Ms get mixed up w/ other conditions
• Symptoms vary from person to person

Question 13

MS - Incidence (life expectancy)

Answer 13

• 1936, 8% survive beyond 20 years after onset of illness
• Now, average population life-expectancy - 7 years
  Because of better treatment and better knowledge of the illness

Question 14

MS - Incidence (cost)

Answer 14

• Cost more than 1 billion / year to canadian economy

Question 15

MS - Causes

Answer 15

• unknown

- considered au autoimmune disease in which the immune system attacks the tissue by accident

Question 16

MS - T-cell and Monocytes

Answer 16

Destroy the myelin sheath

Question 17

MS - Risk factors (8)

Answer 17

• Age
• Sex
• Family history
• Certain infections
• Climate
• Certain autoimmune diseases
• Smoking
• Race

Question 18

MS - incidence per population (inuit)

Answer 18

19 per 100 000

Question 19

MS - incidence per population (scottish)

Answer 19

• 200 per 100 000

- Highest rate

Question 20

MS - ratio of white to non-white people

Answer 20

2:1

Question 21

MS - Symptoms

Answer 21

Differ greatly from each person and over the course of the disease depending on type and location

Question 22

MS - types of lesion locations (5)

Answer 22

• Optic nerve lesion
• Brain stem lesion
• Cerebellum and cerebrum lesion
• Motor nerve tract lesion
• Sensory nerve tract lesion

Question 23

MS - Symptoms associated to optic nerve lesion

Answer 23

Blurred vision

Question 24

MS - Symptoms associated to brain stem lesion

Answer 24

Dizziness and double vision

Question 25

MS - Symptoms associated to Cerebellum and cerebrum lesion

Answer 25

Balance and speech problems, uncoordinated mvt and tremors

Question 26

MS - Symptoms associated to motor nerve tract lesion

Answer 26

Muscle weakness, spasticity paralysis, bladder and bowel impairments

Question 27

MS - Symptoms associated to sensory nerve tract lesion

Answer 27

Altered sensation, numbness, prickling, burning sensations

Question 28

MS - other symptoms

Answer 28

- Fatigue (78% of all patient) | - Tremor, lack of coordination or unsteady gate

Question 29

MS walking pattern

Answer 29

Lack of opposition of arms and legs

Question 30

Course of MS - best scenario

Answer 30

Exacerbation -> Remission

Question 31

Course of MS - Luckiest scenario

Answer 31

Exacerbation -> Myelin becomes inflames -> No scar formation -> Complete recovery -> No loss of function

Question 32

Course of MS - Worst scenario for more severe crisis

Answer 32

Exacerbation -> Myelin becomes inflames -> Scar formation -> Permanent myelin damage-> Loss of function

Question 33

Course of MS - Synonym of exacerbation

Answer 33

- Flare-up - Attack - Relapse

Question 34

Course of MS - What does therapy help with ?

Answer 34

- Decrease severity | - Decrease frequence of relapse

Question 35

MS - Classification based on

Answer 35

- Rate of disease progression | - Frequency of flare-ups

Question 36

MS - Types (4)

Answer 36

- Relapsing / Remitting MS (RRMS) - Secondary progressive MS (SPMS) - Primary progressive MS (PPMS) - Progressive-relapsing MS (PRMS)

Question 37

Type of MS - Relapsing / Remitting MS (RRMS)

Answer 37

- Most common type - Unpredictable but define by relapses where new symptoms appear or existing one worsen. - Between relapse, recovery is complete or nearly complete - Meds can help

Question 38

Type of MS - Secondary progressive MS (SPMS)

Answer 38

- Over time, less apparent distinct relapses and remission - Disease begins to progress steadily - Half of people with RRMS, worsen 10-20 yrs after diagnosis = increase level of disability - Meds can help

Question 39

Type of MS - Primary progressive MS (PPMS)

Answer 39

- Slow accumulation of disability without defined relapse - Stabilize for periods of time and minor temporary improvement - No periods of remission - 10 % of people w/ MS - Meds cannot help

Question 40

Type of MS- Progressive-relapsing MS (PRMS)

Answer 40

- Rarest type = only 5% of MS cases - Experience relapses with or without recovery - Steadily worsening disease from the beginning - Meds can help

Question 41

MS and exercise - Guidelines

Answer 41

- Reduce fatigue - Improve mobility - Enhance elements of health-related quality of life

Question 42

MS and exercise - Who guidelines for?

Answer 42

Adults with mild to moderate MS resulting from relapsing remitting or progressive forms of MS

Question 43

MS and exercise - Is KCEP qualified to train MS client

Answer 43

Yes

Question 44

MS and exercise - Aerobic activity

Answer 44

- 2x / week - At least 30 min during each session - Moderate intensity (5-6 / 10) - General rule, you can talk but not sing a song during moderate intensity activity

Question 45

MS and exercise - Aerobic activity types of exercises

Answer 45

- Arm cycling - Walking, leg cycling - Elliptical training

Question 46

MS and exercise - Strength training activity

Answer 46

- 2x / week - Work up to 2 sets of 10-15 - Pick a resistance heavy enough that you can barely finish 10-15 reps of last set

Question 47

MS and exercise - Strength training activity types of exercises

Answer 47

- Weight machines - Free weight - Cable pulleys

Question 48

MS and exercise - Other types of exercises

Answer 48

- Elastics resistance bands | - Aquatic exercise

Question 49

MS vs Exercise - Considerations

Answer 49

- Lower level of fitness (cardiovascular, muscular strength and endurance) - Decrease balance - Fatigue - Heat intolerance - Depression - Exercise doesn't trigger period of exacerbation if done properly

Question 50

MS vs Exercise - Effects of exercise

Answer 50

- Increase aerobic capacity - Increase muscular strength and endurance - Increase quality of life - Increase independence in ADL