1/16
Looks like no tags are added yet.
Name | Mastery | Learn | Test | Matching | Spaced |
---|
No study sessions yet.
Multiple Sclerosis
Inflammatory autoimmune disease of CNS
Characterized by nerve demyelination
Plaque (sclerosis) in brain and spinal cord
Develops into permanent scars
Impaired neve transmission
Symptoms of Multiple Sclerosis
Weakness
Fatigue
Impaired motor function
Numbness
Bowel Dysfunction
Cognitive Dysfunction
Optic neuritis
Nystagmus
Paresthesia
Spasticity
Heat Sensitivity/Impaired Temperature Regulation
Negative Cycle of De-conditioning
Causes of Multiple Sclerosis
Unknown
Possible
Environment
Infections
Genetics
Pathophysiology of MS
Autoreactive T-cells
Myeline sheath deteriorates
Plaques destroy axons
Impairment of nerve conduction
Treatment/Management of MS
No cure
Medications
Exercise
Rehabilitation
Diagnostic Testing of MS
Neurological Exam
MRI
Cerebrospinal Fluid
Blood Test
No specific MS Blood Test
Test for other conditions
Exercise Testing for MS
Determine current state of fitness
Develop appropriate exercise prescription
Cardiorespiratory Testing for MS
Careful consideration on mode
Monitor temperature regulation
Physiological Responses During Exercise from MS
Increased VO2
Steady or decreased BP
Same or increased Body Temperature
Earlier onset muscular fatigue
MS & GXT
Medical clearance needed prior to exercise testing is highly recommended
Include:
6 MWT
Timed Up & Go
Waist-to-hip ratio or BMI
Berg Balance Scale
Functional Gait Assessment
10-m walk test
Five times sit-to-stand
Musculoskeletal GXT
Standard testing is typically okay
1-RM can be used but modified if significant weakness exists
Flexibility GXT
Use goniometers
Patients can be quite inflexibile because of disease progression and level of spasticity
GXT Considerations of MS
Acute symptoms = postpone
Mornings pererable (Less fatigue)
Use RPE and HR
A cycle ergometer is recommended
Recumbent stepping
Arm ergometer
VO2 PEAK: symptom limited, not capacity limited
Muscle strength and endurance standard protocols
8-10 RM
Functional testing
Ex Rx Considerations of MS
Functional Activities
Acute symptoms = Decrease FITT to level of tolerance
Severe symptoms = Focus on maintaining functional mobility and on aerobic exercise and flexibility
Increased rest times between sets and exercises for full muscle recovery
Focus on large postural muscle groups and minimize total number of exercise performed
Ex Rx Goals of MS
Maintain, re-achieve, or even improve general physical and mental health thus improving ADLs
Reduce symptoms
Improve QoL
Lower risk factors for cardiovascular and metabolic disease
Safe and do not exacerbate symptoms
Additional Special Consideration of MS
Medication side effects
Awareness of difference between more general centered mediated MS fatigue and temporary peripheral exercise related fatigue
Cautious of possible dehydration
Cognitive effects