Multiple Sclerosis CAT

Question 1

What is multiple sclerosis (MS)?

Answer 1

• Demyelination of nerves w/in the brain and spinal cord
• Myelin breakdown leads to plaque development, decreased nerve conduction velocity, and eventual failure of impulse transmission

Question 2

Demographics for MS

Answer 2

• Caucasians > African Americans
• 20-35 y/o
• Women > men (2x)
• Temperate climates

Question 3

Classification of MS

Answer 3

• Relapsing-remitting MS
• Secondary-progressive MS
• Primary progressive MS
• Progressive-relapsing MS

Question 4

Relapsing-remitting MS

Answer 4

• a type of MS where you have relapses (symptoms getting worse) followed by recovery
• disability doesn’t get worse between relapses but after each relapse it can end up worse than before

Question 5

Secondary-progressive MS

Answer 5

• follows an initial relapsing-remitting course.
• a progressive worsening of neurologic function (accumulation of disability) over time

Question 6

Primary progressive MS

Answer 6

worsening neurologic function (accumulation of disability) from the onset of symptoms, without early relapses or remissions

Question 7

Progressive-relapsing MS

Answer 7

a rare form of MS that causes steady damage to nerves when symptoms first appear and continues to cause progressive worsening

Question 8

Clinical presentation for MS

Answer 8

• Visual problems
• Paresthesias and sensory changes
• Clumsiness
• Weakness
• Ataxia
• Balance dysfunction
• Fatigue

Question 9

Pharmacological management of MS

Answer 9

• Complex
• ABC drugs classified as immunomodulatory medication

Question 10

PT management of MS

Answer 10

• Regulation of activity level
• Relaxation and energy conservation
• Normalization of tone
• Balance activities
• Gait training
• Core stabilization and control
• Adaptive assistive device training
• Pt and caregiver education

Question 11

Exercise guidelines for pts w/ MS

Answer 11

• Submaximal/endurance
• Exercise in the morning to avoid fatigue
• Frequent rest periods
• Planning activities and put them into smaller steps to avoid fatigue

Question 12

Factors that influence exacerbations

Answer 12

• Heat
• Stress
• Infection
• Trauma
• Pregnancy

Question 13

Cause of death for pts with MS

Answer 13

Secondary complications like disuse atrophy, pressure sores, contractures, pathological fractures, renal infection, and pneumonia