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{{Template:Multiple sclerosis}}
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==Overview==
==Overview==
==Tertiary prevention==
There is strong [[evidence]] that [[exercise]] therapy can improve [[muscle]] function and [[mobility]] in multiple sclerosis patients.
Disease-modifying treatments only reduce the progression rate of the disease but do not stop it. As multiple sclerosis progresses, the symptomatology tends to increase. The disease is associated with a variety of symptoms and functional deficits that result in a range of progressive impairments and [[Disability|handicap]]. Management of these deficits is therefore very important. Both drug therapy and [[neurorehabilitation]] have shown to ease the burden of some symptoms, even though neither influence disease progression.<ref name="pmid16168933">{{cite journal |author=Kesselring J, Beer S |title=Symptomatic therapy and neurorehabilitation in multiple sclerosis |journal=Lancet neurology |volume=4 |issue=10 |pages=643–52 |year=2005 |pmid=16168933|doi=10.1016/S1474-4422(05)70193-9}}</ref>
As for any patient with neurologic deficits, a multidisciplinary approach is key to limiting and overcoming disability; however there are particular difficulties in specifying a ‘core team’ because people with MS may need help from almost any health profession or service at some point.<ref name="isbn = 1 86016 182 0">{{cite book | last = The Royal College of Physicians |title = Multiple Sclerosis. National clinical guideline for diagnosis and management in primary and secondary care | publisher = Sarum ColourView Group | date = 2004 | location = Salisbury, Wiltshire |  isbn = 1 86016 182 0}}[http://www.rcplondon.ac.uk/pubs/books/MS/MSfulldocument.pdf Free full text] ([[2004-08-13]]). Retrieved on [[2007-10-01]].</ref>Similarly for each symptom there are different treatment options. Treatments should therefore be individualized depending both on the patient and the physician
===Mobility restrictions===
Interventions may be aimed at the level of the impairments that reduce mobility; or at the level of disability. At this second level interventions include provision, education and instruction in use of equipment such as walking aids, wheelchairs,  motorized scooters and car adaptations; and instruction about compensatory strategies to accomplish an activity, (for example,undertaking safe transfers by pivoting in a flexed posture rather than standing up and stepping around).
 
===Spasticity===
There are also [[palliative]] measures like [[casting]]s, [[splint (medical)|splints]] or customised seatings.<ref name="isbn = 1 86016 182 0">{{cite book | last = The Royal College of Physicians |title = Multiple Sclerosis. National clinical guideline for diagnosis and management in primary and secondary care | publisher = Sarum ColourView Group | date = 2004 | location = Salisbury, Wiltshire | isbn = 1 86016 182 0 }}[http://www.rcplondon.ac.uk/pubs/books/MS/MSfulldocument.pdf Free full text]([[2004-08-13]]). Retrieved on[[2007-10-01]].</ref>
 
 
 
===Tremors and ataxia===


[[Physical therapy]] is not indicated as a treatment for tremor or ataxia; however, the use of different [[Orthotics|orthese]]devices can help. An example is the use of wrist bandages with weights, which can be useful to increase the [[inertia]] of movement and therefore reduce tremor.<ref>{{cite journal |author=Aisen ML, Arnold A, Baiges I, Maxwell S, Rosen M |title=The effect of mechanical damping loads on disabling action tremor |journal=Neurology |volume=43 |issue=7 |pages=1346-50 |year=1993 |pmid=8327136|doi=}}</ref> Daily use objects have also to be adapted so they are easier to grab and use.
==Tertiary Prevention==
* The [[drugs]] which are used to treat [[MS]] can reduce the [[progression]] of the [[disease]] and delay [[disability]] occurrence,but cannot stop the [[disease]]. <ref name="pmid16168933">{{cite journal |author=Kesselring J, Beer S |title=Symptomatic therapy and neurorehabilitation in multiple sclerosis |journal=Lancet neurology |volume=4 |issue=10 |pages=643–52 |year=2005 |pmid=16168933|doi=10.1016/S1474-4422(05)70193-9}}</ref>
* [[Disability|Disabilities]] appear so controlling them can be beneficial in increasing [[MS]] [[patients]]’ [[quality of life]].
* There is strong evidence that [[exercise]] therapy can improve [[muscle]] function and [[mobility]] in multiple sclerosis patients.<ref name="pmid15674920">{{cite journal |vauthors=Rietberg MB, Brooks D, Uitdehaag BM, Kwakkel G |title=Exercise therapy for multiple sclerosis |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD003980 |date=January 2005 |pmid=15674920 |doi=10.1002/14651858.CD003980.pub2 |url=}}</ref>
* For controlling [[tremor]] and [[ataxia]], [[Orthotics|orthotic]] devices can be very helpful.<ref>{{cite journal |author=Aisen ML, Arnold A, Baiges I, Maxwell S, Rosen M |title=The effect of mechanical damping loads on disabling action tremor |journal=Neurology |volume=43 |issue=7 |pages=1346-50 |year=1993 |pmid=8327136|doi=}}</ref>


==References==
==References==
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[[Category:Neurology]]
[[Category:Orthopedics]]
[[Category:Rheumatology]]

Latest revision as of 22:48, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

There is strong evidence that exercise therapy can improve muscle function and mobility in multiple sclerosis patients.

Tertiary Prevention

References

  1. Kesselring J, Beer S (2005). "Symptomatic therapy and neurorehabilitation in multiple sclerosis". Lancet neurology. 4 (10): 643–52. doi:10.1016/S1474-4422(05)70193-9. PMID 16168933.
  2. Rietberg MB, Brooks D, Uitdehaag BM, Kwakkel G (January 2005). "Exercise therapy for multiple sclerosis". Cochrane Database Syst Rev (1): CD003980. doi:10.1002/14651858.CD003980.pub2. PMID 15674920.
  3. Aisen ML, Arnold A, Baiges I, Maxwell S, Rosen M (1993). "The effect of mechanical damping loads on disabling action tremor". Neurology. 43 (7): 1346–50. PMID 8327136.

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