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Multiple Sclerosis

Multiple Sclerosis. Epidemiology Common disease affecting every 50 to 100 people out of 100,000 Development of MS may be related to where one resides prior to the age of 15 in relation to the equator Incidence of MS 3 in 100,000 in temperature zones 1 in 100,000 in tropical areas

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Multiple Sclerosis

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  1. Multiple Sclerosis • Epidemiology • Common disease affecting every 50 to 100 people out of 100,000 • Development of MS may be related to where one resides prior to the age of 15 in relation to the equator • Incidence of MS • 3 in 100,000 in temperature zones • 1 in 100,000 in tropical areas • Women are affected more than men by a 2:1 ratio • Initiation or propensity for MS begins in childhood • Possible etiological (causes) • Various infections like exanthemata (a skin eruption related to an acute viral or coccal disease), ie. Measles. • Upper-respiratory infections

  2. Epidemiology • 3:1 increase in episodes of MS after URI • Onset of MS occurs between the ages of 20 and 40 • It is possible for neurological deficits to occur in childhood • Extremity numbness, weakness, blurry vision, diplopia (double vision) • Common comorbidities • Autoimmune related illnesses • Systemic lupus erythematosus • Rheumatoid arthritis • Polymyositis (inflammation of several voluntary muscle groups) • Myasthenia gravis (disorder effecting neuromuscular transmission) • Heredity • First-degree relative with MS • 12 to 20 fold increase in the likelihood of developing MS

  3. Pathophysiology • Central Nervous System disease • Multiple areas of inflammatory demyelination • Tendency for effecting the ventricles and vascular spaces • CNS damage occurs to the myelin and axons • Immune reaction to myelin • Lesions represented by focal areas of inflammatory demyelination • Cerebral hemispheres • Brain stem • Spinal cord • Long fiber pathways or tracts are commonly affected by the demyelination process

  4. Common Signs & Symptoms • Painful blurring or loss of vision in one eye • Leads to loss of visual acuity • Facial numbness • Numbness of the tongue and a loss of taste • Lower extremity weakness then upper body weakness • Spastic paraparesis (lower body) along with ataxia (incoordination of muscle movements) • Loss of bladder control (lower bladder volumes) • Sexual dysfunction (impotence) • Severe constipation (bowel problems) • Loss of sensory abilities (sensing vibrations)

  5. Medical and Surgical Treatments • High doses of adrenocortical steroids • Methylprednisolone • Prophylactic treatments • Interferon beta 1a and 1b • Reduce lymphocytic invasion of the brain • Glatiramer • Possible chemotherapy for chronic progressive disease

  6. Acute Exercise Response • Overwhelming sense of fatigue • Muscular force is generally lower • CV abilities vary greatly depending upon the individual • Normal HR, BP, and VO2 responses • VO2 values tend to be lower • Aerobic endurance tends to be slightly lower

  7. Exercise Prescription • ADL’s • Increase daily activity energy expenditure • Aerobic and endurance exercise • 60-75% of HR peak • 50-65% of VO2 peak • 3 sessions per week • 30 minutes total (1 x 30, 2 x 15, or 3 x 10) • Resistance training • General muscle strength and endurance • Perform on non-endurance training days • Flexibility & Balance training • Increase range of motion • Improve kinesthetic awareness

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