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Multiple Sclerosis. Claire Hamshire. Definition. “ An acquired inflammatory demyelinating disease of the central nervous system”. Aetiology and Epidemiology. Cause – unknown Environmental and genetic factors implicated Female : Male ratio Age. Classifications. Benign

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Multiple sclerosis l.jpg

Multiple Sclerosis

Claire Hamshire


Definition l.jpg
Definition

“An acquired inflammatory demyelinating disease of the central nervous system”


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Aetiology and Epidemiology

  • Cause – unknown

  • Environmental and genetic factors implicated

  • Female : Male ratio

  • Age


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Classifications

  • Benign

  • Relapsing / Remitting

  • Secondary progressive

  • Primary progressive




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Diagnosis

  • Neurologist

  • Tests – MR scan, lumbar puncture

  • Differential diagnosis



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Clinical features (variable)

  • Sensory problems

  • Motor problems

  • Bladder / bowel dysfunction

  • Fatigue

  • Heat sensitivity

  • Cognitive / emotional dysfunction

  • Sexual dysfunction


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Secondary complications

  • Disuse atrophy

  • Abnormal tone

  • Pain

  • Contractures

  • Pressure sores

  • Chest infections

  • UTI


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Aims of Physiotherapy

The course of the disease cannot be influenced by physiotherapy, however we can help to:

  • maximise function

  • maintain and increase ROM

  • prevent secondary complications

  • prevent contractures

  • maintain and encourage weight bearing


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Physiotherapy Management

Education

Treat clinical signs

Consider type of disease progression

Consider stage of disease

Open access

Open access team approach

Consider carers

Employment

Moving and Handling

Aids and adaptations

Palliative

Monitoring / Outcome Measures


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Aspects of treatment

  • Modulate abnormal muscle tone

  • Facilitate normal movement

  • Balance re-education

  • Increase co-ordination

  • Stretching programme

  • Management of fatigue

  • Pain control

  • Relaxation

  • Walking aids

  • Pelvic floor rehabilitation

  • Functional exercises


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M.S. Society Guidelines

  • Standards of healthcare for people with M.S.

  • Basics of best practice in the management of M.S.

  • People with M.S. in long term care

    www.mssociety.org.uk


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Standards of healthcare for people with M.S.

  • Access

  • Support

  • Information

  • Informed advice

  • Treatment and self management

    - responsive

    - co-ordinated


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N.I.C.E clinical guidelines

  • CSP and RCP professional leads

  • Broad range of care services

  • Different forms of M.S.

  • Interaction with Social Services / Voluntary sector

  • Diagnosis, Drugs, Rehabilitation, Alternative Therapies

  • Prevention of secondary problems

  • Management of Impairment and Disabilities

    www.nice.org.uk


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Drug Therapy

  • Anti inflammatory & Immunosupression

    - steroids

    - Azothiopine, Methotrexate

  • Immuno modulation

    - Beta-interpheron


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MS case / video

  • Watch the video

  • Information in study pack - “Jackie”

  • Task in study pack


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