Multiple Sclerosis

Question 1

what system(s) involved? A) Orthopedic, B) Neuro,
C) Pulmonary, D) Immune

Answer 1

neuro and immune

Question 2

Incidence (when MS strikes) ?

Answer 2

20 to 40 y/old

Question 3

is MS curable

Answer 3

not yet

Question 4

what is MS

Answer 4

MS is a chronic, progressive disease
that leads to increasing disability in
most individuals

Question 5

Sclerosis =

Answer 5

‘Sclerosed’ or hardened
tissue in damaged areas

Question 6

Immune system attacks

Answer 6

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

Question 7

No cure but medications can help:

Answer 7

1. speed recovery from attacks
2. modify the course of the disease
   and symptoms

Question 8

MS lesions can affect

Answer 8

the brain and/or the spinal cord

Question 9

how many Canadians have MS

Answer 9

90 000 (1 in 400 people)

Question 10

most common central nervous system disease among

Answer 10

young adults ( 20 to 40 )

Question 11

Cost of MS in Canada per year

Answer 11

between 1.5$ and 2 billion per year

Question 12

meds per patient per year

Answer 12

12 000 to 60 000$/ per year

Question 13

Avg age of clinical onset is

Answer 13

30–33 years of age

Question 14

the avg age of diagnosis is

Answer 14

37…

Question 15

Why such a delay? 3

Answer 15

1. symptoms come and go
2. MS gets mixed with other conditions
3. symptoms vary from person to person

Question 16

In 1936, only ___ of patients were reported to survive beyond 20 years after onset of illness

Answer 16

8%

Question 17

a patient can now expect to live…

Answer 17

the average population life-expectancy minus seven year

Question 18

causes of disease

Answer 18

Unknown

Question 19

auto immune disease in which

Answer 19

the body’s immune system attacks its own tissues by mistake

Question 20

T-cell =

Answer 20

destroy the myelin sheath

Question 21

monocytes =

Answer 21

destroys the myelin sheath

Question 22

risk factors

Answer 22

There is no single risk factor that
provokes MS, but several factors are believed to contribute to the overall risk

Question 23

what factors increase risk of developing MS

Answer 23

Age
Sex
Family history
Certain factors
Climate
Certain autoimmune diseases
Smoking
Race

Question 24

age factor

Answer 24

MS can occur at any age, but most commonly affects people between the ages of 20 and 40.

Question 25

Sex factor

Answer 25

Women are about twice as likely as men to develop MS.

Question 26

family history risk

Answer 26

If one of your parents or siblings has had MS, you are at higher risk of developing the disease.

Question 27

Certain infections

Answer 27

A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis

Question 28

Climate

Answer 28

MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe

Question 29

Certain autoimmune diseases

Answer 29

You have a slightly higher risk of developing MS if you have thyroid disease, type 1 diabetes or inflammatory bowel disease

Question 30

Smoking.

Answer 30

Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS

Question 31

Race.

Answer 31

White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk

Question 32

inuit people ratio

Answer 32

19 per 100 000

Question 33

Ratio of white to non- white people =

Answer 33

2:1

Question 34

nervous system lesions

Answer 34

optic brainstem cerebellum motor nerve tract sensory nerve tract

Question 35

optic lesion

Answer 35

caused blurred vision

Question 36

brain stem lesion

Answer 36

dizziness and may cause double vision

Question 37

cerebellum and cerebrum lesions

Answer 37

balance problems, speech problems, uncoordinated movements and tremors

Question 38

motor nerve tract lesion

Answer 38

muscle weakness, spasticity paralysis, bladder and bowel impairments

Question 39

sensory nerve tract lesion

Answer 39

altered sensation, numbness, prickling, and burning sensations

Question 40

symptoms:

Answer 40

lesions fatigue (78% of all patients) tremor, lack of coordination or unsteady gait

Question 41

synonym of exacerbation

Answer 41

flare -up attack relapse

Question 42

myelin becomes inflamed -> scar formation ->

Answer 42

permanent myelin damage -> loss of function

Question 43

myelin becomes inflamed -> no scar formation ->

Answer 43

complete recovery -> no loss of function

Question 44

MS classification is based on

Answer 44

1. rate of disease progression 2. frequency of flare-ups

Question 45

types of MS

Answer 45

1. relapsing/remitting RRMS 2. secondary progressive MS 3. Primary progressive MS 4. Progressive-relapsing MS

Question 46

relapsing (most common)

Answer 46

Unpredictable but clearly defined relapses (also known as attacks, exacerbations or flare-ups) during which new symptoms appear or existing ones get worse

Question 47

secondary progressive MS

Answer 47

* Follows a diagnosis of RRMS. Over time, distinct relapses and remissions become less apparent and the disease begins to progress steadily (figure 2a), sometimes with plateaus * About half of people with RRMS start to worsen within 10-20 years of diagnosis, often with increasing levels of disability (figure 2b)

Question 48

Primary Progressive MS (PPMS)

Answer 48

* Slow accumulation of disability, without defined relapses (figure 3a) * May stabilize for periods of time, and even offer minor temporary improvement (figure 3b) but overall, there are no periods of remission. Approximately 10 per cent of people diagnosed with MS have PPMS

Question 49

Progressive-Relapsing MS (PRMS)

Answer 49

* The rarest course of MS, occurring in only about 5 % of MS cases * People with this form of MS experience relapses with (figure 4a) or without (figure 4b) recovery and steadily worsening disease from the beginning

Question 50

fitness guidelines

Answer 50

mild to moderate disability

Question 51

who are guidelines for

Answer 51

These guidelines are appropriate for adults (aged 18-64 years) with minimal to moderate disability resulting from either relapsing remitting or progressive forms of multiple sclerosis

Question 52

aerobic activity, how often, how much

Answer 52

2 times per week, at least 30 mins of aerobic activity during each workout session

Question 53

strength activity, how often, how much

Answer 53

2 times per week, doing 2 sets of 10-15

Question 54

aerobic activity how hard

Answer 54

Moderate-intensity physical activity is usually a 5 or 6 on a scale of 10, and causes your heart rate to go up. As a general rule if you're doing moderate-intensity activity you can talk, but not sing a song, during the activity.

Question 55

aerobic activity, how to?

Answer 55

* Upper Body Exercises: arm cycling * Lower Body Exercises: walking, leg cycling * Combined Upper and Lower body exercises: elliptical traine

Question 56

strength training, how hard?

Answer 56

Pick a resistance (free weights, cable pulleys, bands, etc.) heavy enough that you can barely, but safely, finish 10-15 repetitions of the last set

Question 57

strength training, how to?

Answer 57

Strength training activities for the upper and lower body * Weight machines * Free weights * Cable pulleys

Question 58

MS vs Exercise / Special considerations

Answer 58

– Lower level of fitness : cardiovascular, muscular strength and endurance (↓ balance) – Fatigue – Heat intolerance (↑0.5°) – Depression – Exercise does not trigger periods of exacerbation when properly managed

Question 59

Effects of exercise

Answer 59

– ↑ aerobic capacity – ↑ muscular strength and endurance – ↑ quality of life – ↑ independence in ADLs