Clinical Management of MS Flashcards
(51 cards)
Name some Clinical Manifestations of MS
- Fatigue
- Sensory Disturbances
- Motor Impairments
- Bowel & bladder
- Sexual dysfunction
- Cognitive Impairments
- Depression
- Heat intolerance
- Visual Disturbances
- Communication Limitations
- Various Secondary Limitation
Name some functional observations that should be made during an examination of a patient with MS
- Bed mobility
- Transitions
- Transfers
-Ambulation/Stairs/Ramps/Curbs - Wheeled Mobility
- ADLs/IADL’s
What are some ways to examine strength & muscular endurance in patients with MS
- MMT
- Functional Strength Assessment
- Repeated Movement Testing
What testing will give you the most information about fatiguability?
Repeated Movement Testing
What are some SOMs to examine postural control/balance?
- ABC
- BERG*
- Mini Best
- DGI
- Functional Reach Test
- Rivermead Mobility Index
Name some things that you should examine when looking at a patient sensiormotor impairments
- Superficial
- Deep
- Cortical
- Pain
- Vision
- Cranial Nerves
When examining pain in a patient with MS what might you be on the look out for?
- Provoking stimuli
- Headache
- Hyperpathia
- Dysesthesias
- Trigeminal Neuralgia
- Lhermitte’s Sign
What is the MFIS used for?
- Modified Fatigue Impact Scale
- Self report: measuring physical, cognitive, psychosocial function
- Examines past 4 weeks
Name some test & measures to examine gait
- 12 Item MS Walking Scale*
- Timed 25’ Walk Test*(T25FW)
- FGA
- TUG
- 6MWT, 2MWT
- SWOC
- Stair/curb negotiation
What does the RIvermead Mobility Index examine? Does higher score indicate higher or lower function)
- Balance
- Higher score = higher function
If a patient scores a 6 on the EDSS what does this indicate?
- Require walking device
- Any score below not using AD
- Any score above they are
What SOM is used for Disease Specific Measures for MS? (Gold standard for disability)
Expanded Disability Status Scale (EDSS)
What score on the EDSS indicates highest risk of falling?
Scores of 4-6
Name some key things that are included in the EDSS?
- Able to walk w/o aid or rest for 500 m
- Essentially restricted to w/c
- Restricted to bed much of day
- Has some effective use of arms
Name some additional disease specific measures for MS
- Multiple Sclerosis Quality of Life - 54 (MSQOL-54)
- MS Quality of Life Inventory (MSQLI)
- Multiple Sclerosis Impact Scale (MSIS-29)
How is the diagnosis of MS made?
- McDonald Criteria (medical)
- Motor sx use lables that identify “impact of condition on function at the level of the system)
Why is the prognosis of MS greatly variable?
Rate of progression affected by multiple intrinsic & extrinsic factors
Name some unfavorable thing that affect the PT prognosis
- Male after 40 yr of age
- Initial sx involving cerebellum, mental function, urinary control affecting multiple regions
- Frequent or short time b/w exacerbation w/ incomplete remissions
- Obesity
- Smoking
Name some favorable things that affect the PT prognosis
- Female before 40 yrs of age
- Initial sx sensory only
- Involvement of only on CNS region
- Full recovery
- Absence/ late onset cerebellar sx
- BMI WNL; No smoking
What is usually the COD in patients with MS?
- Pneumonia
- Infections
- Falls/fear of falling
- Suicide
- Heart disease due to inactivity
T/F: Physical activity & exercises is now considered to be disease modifying (considered neuroprotective)
True
- Reduced relapse rate
- Decreased mobility disability & progression
- Decreased lesion volume & load
What are the most common clinical presentation of MS?
- Fatigue
- Walking Difficulty
- Numbness, tingling
- Pain
- Muscle Spasms
What of the musculoskeletal system should be examined in pts with MS?
- AROM/PROM
- Strength & Muscular Endurance
- Posture
What types of postures should be examined in patients with MS?
Functional positions for that specific patients
