Stanbridge - T6 - Neuro2 - W6 - Multiple Sclerosis

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Questions and Answers

Which of the following is characteristic of the epidemiology of Multiple Sclerosis (MS)?

  • Incidence rates are lower in temperate climates.
  • Onset is most common between 20-40 years of age. (correct)
  • Males have a two-time higher incidence than females.
  • Onset is most common between 50-70 years of age.

What is the underlying cause of Multiple Sclerosis (MS)?

  • Prolonged exposure to environmental toxins.
  • Its etiology is currently unknown. (correct)
  • A bacterial infection that attacks the nervous system.
  • A genetic mutation that directly causes demyelination.

Patches of demyelination in the white matter of the brain and spinal cord, leading to decreased responsiveness of the nervous system, are most closely related to which of the following?

  • Epidemiology of MS
  • Pathophysiology of MS (correct)
  • Etiology of MS
  • Definition of MS

Which cell type is primarily responsible for creating the myelin sheath in the central nervous system?

<p>Oligodendrocytes (C)</p> Signup and view all the answers

A patient reports experiencing an initial episode of neurological symptoms consistent with MS that lasted for 24 hours. According to the material, what is the MOST appropriate classification?

<p>Clinically Isolated Syndrome (CIS) (A)</p> Signup and view all the answers

Which of the following is the primary mechanism of action of Copaxone in the treatment of Multiple Sclerosis?

<p>Reducing inflammation at lesion sites and reducing the frequency of attacks. (B)</p> Signup and view all the answers

A patient with MS reports a new onset of blurred vision, which worsens later in the day at the gym. This is MOST consistent with:

<p>Uhthoff phenomenon (B)</p> Signup and view all the answers

What is the MOST likely cause of urinary retention as a clinical feature of Multiple Sclerosis?

<p>Impaired reflex control of the bowel and bladder. (B)</p> Signup and view all the answers

Which diagnostic finding would be MOST indicative of Multiple Sclerosis?

<p>Presence of oligoclonal bands in cerebral spinal fluid. (D)</p> Signup and view all the answers

A patient with MS is experiencing increased muscle spasms. Which of the following medications would be MOST appropriate to address this symptom?

<p>Dantrium (A)</p> Signup and view all the answers

What recommendation should a therapist emphasize regarding strength training for a patient with Multiple Sclerosis?

<p>Low intensity, frequent repetitions with rest breaks to avoid fatigue. (A)</p> Signup and view all the answers

A physical therapist is treating a patient with MS who exhibits ataxia. Which intervention would be MOST appropriate?

<p>Balance training using a tilt board. (B)</p> Signup and view all the answers

To improve proprioceptive awareness, what interventions would be MOST appropriate for your patient?

<p>Gait training with distal weights to the wrists and ankles. (C)</p> Signup and view all the answers

A patient with MS presents with moderate spasticity. According to the provided resource material, which AFO might be contraindicated?

<p>Standard polypropylene AFO (C)</p> Signup and view all the answers

Which of the following is a negative aspect of using a double upright metal with articulating ankle joint AFO?

<p>Poor cosmesis (B)</p> Signup and view all the answers

What is the percent chance that a child will get Huntington's disease if one of their parents has it?

<p>50% (B)</p> Signup and view all the answers

All of the following describe the signs and symptoms of Huntington's disease, EXCEPT:

<p>Increased memory and focus (C)</p> Signup and view all the answers

Which of the following motor symptoms is associated with Huntington's Disease?

<p>Voluntary jerking or writing movements (B)</p> Signup and view all the answers

If you observe involuntary movements affective all muscles of the body in your patient, which is the MOST appropriate term to use?

<p>Chorea (A)</p> Signup and view all the answers

Select the medication which is NOT used to treat chorea:

<p>Lexapro (A)</p> Signup and view all the answers

What is the MOST common mental health condition associated with Huntington's Disease?

<p>Depression (C)</p> Signup and view all the answers

In the early stages of Huntington's disease, what is a key role for the physical therapist?

<p>Prevention of mobility restrictions (C)</p> Signup and view all the answers

Which of the following exercises has the MOST support (evidence) for improving function in patients with Huntington's Disease?

<p>Aerobic and strengthening (A)</p> Signup and view all the answers

Which guideline is BEST to follow when treating patients with distractibility and agitation?

<p>Complete therapy in a quiet room. (B)</p> Signup and view all the answers

What is the definition of motor control?

<p>The ability to maintain and change postures and movement. (C)</p> Signup and view all the answers

Which stage of motor control involves the ability to maintain a steady position in a weight-bearing, antigravity posture?

<p>Stability (B)</p> Signup and view all the answers

Motor learning is BEST described by which description?

<p>A permanent change in motor performance due to practice or experience. (A)</p> Signup and view all the answers

During which stage of Fitts' stages of motor learning is the task new to the learner, requiring active thought about the goal?

<p>Cognitive (B)</p> Signup and view all the answers

In which phase of motor learning should extrinsic feedback be VERY limited?

<p>Autonomous phase (D)</p> Signup and view all the answers

Which of the following types of feedback is MOST effective for long-term motor learning?

<p>Faded feedback that decreases over time. (A)</p> Signup and view all the answers

A patient with Multiple Sclerosis is learning to use crutches. For optimal motor learning, which practice schedule is MOST effective?

<p>Distributed practice, with rest intervals. (A)</p> Signup and view all the answers

What type of learning involves associating stimuli and responses through repetition?

<p>Associative learning (A)</p> Signup and view all the answers

A patient is learning a new balance strategy that requires dividing their attention from the task itself. Which type of attention is being challenged?

<p>Divided Attention (D)</p> Signup and view all the answers

Which area of the brain is MOST crucial for higher-level cognitive functions such as working memory, attention control, and abstract thinking?

<p>Dorsolateral Prefrontal Cortex (DLPFC) (D)</p> Signup and view all the answers

All of the following are clinical strategies for improving working memory EXCEPT:

<p>Working on the motor task and nothing else (C)</p> Signup and view all the answers

Which change in motor performance is typical for Older Adults to display in comparison to younger adults?

<p>Slower learning with greater errors despite practice. (D)</p> Signup and view all the answers

Which clinical finding is MOST associated with dysesthesias in patients with Multiple Sclerosis?

<p>Abnormal burning or aching sensations. (D)</p> Signup and view all the answers

A patient with MS reports experiencing graying and blurring of vision. Which condition is MOST likely contributing to these symptoms:

<p>Inflammation of the optic nerve. (D)</p> Signup and view all the answers

Which of the following BEST describes scanning speech, often seen in individuals with Multiple Sclerosis?

<p>Slow speech with long pauses and a lack of fluidity. (B)</p> Signup and view all the answers

A patient with MS reports that their fatigue increases with elevated ambient temperatures. This is MOST consistent with which phenomenon?

<p>Uhthoff's phenomenon. (C)</p> Signup and view all the answers

A patient with MS is experiencing difficulties with problem-solving, short-term memory, and visual-spatial perception. Which of the following is the MOST likely cause of these cognitive impairments?

<p>Demyelination lesions in the frontal lobe. (D)</p> Signup and view all the answers

What combination of clinical findings is required to confirm a Multiple Sclerosis diagnosis?

<p>Two or more lesions disseminated in the brain or spinal cord, damage occurred at different times, and all other possible diagnoses ruled out. (C)</p> Signup and view all the answers

Which medication is designed to shorten the duration of acute attacks in multiple sclerosis?

<p>Cortisone. (C)</p> Signup and view all the answers

When initiating strength training for a patient with MS, which strategy is MOST important to implement?

<p>Low-intensity exercises with frequent repetitions and rest. (D)</p> Signup and view all the answers

A patient with MS is beginning a non-fatiguing strengthening protocol. How long should the patient contract their muscles during each non-fatiguing strengthening exercise?

<p>5 seconds. (C)</p> Signup and view all the answers

A physical therapist is developing a spasticity management plan for a patient with MS. Which intervention should be MOST appropriate?

<p>Slow, static stretching. (C)</p> Signup and view all the answers

When performing PNF techniques for a patient with spasticity, what is the MOST appropriate component to incorporate?

<p>Rotational movements. (B)</p> Signup and view all the answers

A patient with MS is experiencing ataxia. Which intervention is MOST suitable for improving coordination and control?

<p>Frenkel exercises. (D)</p> Signup and view all the answers

What is the overarching goal for physical therapy management in the EARLY stages of Huntington's disease?

<p>Preventing mobility restrictions. (C)</p> Signup and view all the answers

Which of the following BEST describes chorea, a common movement disorder associated with Huntington's disease?

<p>Involuntary, rapid, jerky movements affecting multiple muscle groups. (D)</p> Signup and view all the answers

During the middle stage of Huntington's disease, patients may exhibit several motor and cognitive changes. Which of the following BEST describes the typical impairments?

<p>Inability to work or drive, increased chorea prominence, impaired balance, and difficulty problem-solving. (D)</p> Signup and view all the answers

Which of the following interventions has the strongest evidence for improving outcomes in patients with Huntington's Disease?

<p>Aerobic and strengthening exercises. (B)</p> Signup and view all the answers

According to clinical practice guidelines, what is the recommendation for balance exercises in persons with HD?

<p>Weak recommendation. (A)</p> Signup and view all the answers

What factor related to Huntington's Disease should be considered when performing physical therapy in a home environment?

<p>Issues with transportation. (D)</p> Signup and view all the answers

Which of the following strategies would be most helpful in treating a patient with HD who is easily distracted?

<p>Completing tasks in a quiet room. (B)</p> Signup and view all the answers

What is the role of the therapist during the associative stage of motor learning?

<p>Refine and improve movement through intrinsic feedback. (C)</p> Signup and view all the answers

Which of the following is MOST representative of the mobility stage of motor control?

<p>Available ROM to assume a posture and sufficient motor activity to initiate movement. (D)</p> Signup and view all the answers

A physical therapist is using verbal cues to guide a patient's movements during a new exercise. At which stage of motor learning is the patient MOST likely functioning?

<p>Cognitive. (D)</p> Signup and view all the answers

Which of the following is BEST to incorporate during the autonomous stage of motor learning?

<p>Limited extrinsic feedback. (D)</p> Signup and view all the answers

What form of feedback is useful to use to provide at the end of the task?

<p>Knowledge of results. (D)</p> Signup and view all the answers

If a patient is unable to self-correct using internal feedback, what can the PTA do?

<p>Develop activities to regain the sensory system or substitute with another sensory system. (A)</p> Signup and view all the answers

A therapist is teaching a patient with impaired motor control to reach for a glass of water. The therapist initially provides feedback after every trial, but then gradually reduces the frequency of feedback as the patient's performance improves. Which type of feedback schedule are they utilizing?

<p>Faded. (A)</p> Signup and view all the answers

A physical therapist is working with a patient on a complex motor task and wants to enhance long-term retention and skill transfer. Which practice method would be MOST effective?

<p>Variable practice. (A)</p> Signup and view all the answers

What is the definition of non-associative learning?

<p>Changes in response to a stimulus due to repeated exposure. (C)</p> Signup and view all the answers

The ability to learn a task by forming movement habits through repetitive practice describes which of the following types of learning?

<p>Procedural learning. (C)</p> Signup and view all the answers

A patient is performing a balance exercise while simultaneously reciting a list of words. This dual-task activity primarily challenges which type of attention?

<p>Divided attention. (A)</p> Signup and view all the answers

Which of the following is MOST crucial for the ability to focus attention and filter out distractions?

<p>Attention control. (B)</p> Signup and view all the answers

Increased difficulty with bimanual coordination in older adults is MOST closely related to which factor?

<p>Sequential learning. (A)</p> Signup and view all the answers

What type of practice is beneficial use with children?

<p>Blocked practice. (D)</p> Signup and view all the answers

In motor learning, what does the term "distributed practice" mean?

<p>Sessions are spaced apart or interleaved with other skills. (D)</p> Signup and view all the answers

What type of memory is involved in a task that requires sustained attention?

<p>Working memory. (B)</p> Signup and view all the answers

In order to improve motor learning and attention, what is something that the patient requires?

<p>Motivation. (B)</p> Signup and view all the answers

Which of the following strategies is MOST likely to improve working memory for patients with neurological conditions?

<p>Educate and provide feedback. (C)</p> Signup and view all the answers

Which statement BEST relates the role of experience to motor control?

<p>Experience is essential for motor learning, which refines motor control. (B)</p> Signup and view all the answers

Which of the following is an example of 'distributed practice' in motor learning?

<p>Periods of rest are greater than the amount of time spent practicing. (B)</p> Signup and view all the answers

In the context of ataxia management, which of the following interventions aims to improve coordination and control by increasing proprioceptive awareness?

<p>Using PNF techniques such as alternating isometrics and rhythmic stabilization (D)</p> Signup and view all the answers

A patient with MS is in the cognitive stage of learning a new sit-to-stand transfer. What is the MOST appropriate intervention?

<p>Offer detailed verbal cues and demonstration of each component of the task. (A)</p> Signup and view all the answers

What type of learning is involved when a patient with Huntington's disease gradually improves their ability to perform activities of daily living through repeated practice and habit formation?

<p>Procedural learning (B)</p> Signup and view all the answers

A physical therapist is treating a patient with Huntington's disease who exhibits agitation and impulsivity. Which strategy is MOST appropriate for managing these behaviors during therapy sessions?

<p>Maintaining a calm and quiet environment with minimal distractions. (B)</p> Signup and view all the answers

A patient in the middle stages of Huntington's disease is prescribed gait training. To address the cognitive and motor challenges, which approach is MOST suitable:

<p>Dual-task gait training that incorporates cognitive tasks to improve attention (D)</p> Signup and view all the answers

What is the MOST accurate description of the 'associative' stage of motor learning?

<p>The learner begins to refine their movements and reduce errors through practice. (B)</p> Signup and view all the answers

A patient with MS reports increased fatigue during exercise. Which intervention strategy is MOST appropriate to manage this symptom?

<p>Implementing a non-fatiguing strengthening protocol with short contraction times and rest intervals (C)</p> Signup and view all the answers

You are working with a patient with ataxia on PNF techniques and want to incorporate rhythmic stabilization. What is the PRIMARY goal of this technique?

<p>Enhance stability through co-contraction of muscles around a joint. (A)</p> Signup and view all the answers

Which of the following is the MOST accurate description of 'divided attention'?

<p>The ability to perform two or more tasks simultaneously. (C)</p> Signup and view all the answers

Flashcards

Multiple Sclerosis (MS)

Chronic debilitating disease that results from demyelination of the nervous system.

MS Onset Age

Onset is typically between 20-40 years of age

MS Gender

Females have a two-time higher incidence than males.

MS: Demyelination

Patches of demyelination occur in the white matter of the brain and spinal cord.

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MS: Myelin Cell Destruction

Cells that make myelin are destroyed preventing re-myelination of the axon.

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MS: Parasthesias

Sensory Symptoms reported as pins and needles

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MS: Dysesthesias

Sensory symptom described as abnormal, burning or aching

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MS: Neuritis Definition

Inflammation of the optic nerve that causes graying or blurring of vision.

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MS: Diplopia

Double vision from optic nerve

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MS:Nystagmus

Involuntary oscillating of an eye from optic nerve damage

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MS: Scanning Speech

Slow, long pauses, lack of fluidity in speech from muscle weakness

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MS: Uhthoff phenomenon

Phenomenon where MS fatigue worsens by heat or increased temperature

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MS: Clinically Isolated Syndrome (CIS)

First episode of neurologic symptoms lasting for 24 hours; not everyone who experiences this will go on to develop MS

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MS: Relapsing-remitting

Definable exacerbations and remissions, most common MS

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MS: Primary Progressive

Relentless progression without relapses which only occurs in 10% of cases

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MS: Secondary-progressive

Begins with relapsing and remissions and then becomes progressive with only occasional relapses and minor remissions

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MS: Diagnosis Criteria

Clinical evidence of at least 2 lesions in the brain, spinal cord, or optic nerve AND Evidence that damage occurred at different times AND Rule out all other possible diagnoses

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MS: CRAB Drugs

Four injectable medications developed to treat MS

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MS Medical Management: Copaxone

Reduces inflammation at the lesion sites, reduces frequency of attacks in MS

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MS Medical Management: Interferons

Medications that modulate the immune system to treat MS

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Physical Therapy: MS Goal

Aims to minimize progression, maintain functional independence, prevent complications, maintain respiratory function Conserve energy & manage fatigue, and provide patient/ family education

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Physical Therapy:Strength Training in MS

Emphasizes low intensity, frequent Repetitions, and rest breaks to avoid fatiguing the Multiple Sclerosis patient

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Huntington's Disease (HD)

Neurologic disorder characterized by involuntary choreic movements, psychiatric issues, and cognitive decline

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Is HD a heredity disease?

HD is a heredity disease: autosomal dominant trait

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HD: Chorea

Movement disorder characterized by involuntary choreic movements

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HD Medications to Reduced Chorea Symptoms

Medications prescribed to treat chorea, Tetrabenzine, deuteretrabenzine and valbenazine FDA approved medications that suppress chorea, but don't effect how the disease progresses

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HD Cognitive Impairments May Include:

difficulty organizing, prioritizing or focusing on tasks with impaired impulse control and difficulty learning new information

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Stages of HD: Psychological Symptoms

Early, middle and late stages: depression, irritabilty, disinhibition, dysphagia, weight loss, and loss of ADLS

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Motor Learning is:

a process that brings about a permanent change in motor performance as a result of practice or experience.

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Phases of motor learning: Cognitive

Task is new to the learner, actively performs verbal cognitive and motor performance, PTA visually demonstrates while verbally explaining the goal of motor function.

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Phases of motor learning: Associative

Begins utilizing intrinsic feedback to detect errors, and improves sensory feedback

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Motor Learning: Autonomous Phase

Opens loop feedback with automatic fluid movements

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Extrinsic Feedback: Summary

feedback given after a set number of trials

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Feedback: Faded

feedback initially provides feedback after every trial but then decreases

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Extrinsic Feedback: Delayed

Feedback witheld for (e.g. 5 sec delay) after task has been performed

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Motor Learning Time

Factors that affects how long motor learning will take to occur

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Types of leanring and memory: Non-associative learning

Change in response to a stimulus due to repeated exposure, habituation

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Types of Learning & Memory: Associative Learning

Learning based on forming associations between stimuli and responses, Classical conditioning

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Learning and Memory: Procedural (non-declarative) Learning

learning without conscious awareness, often through exposure, A task is learning by forming movement habits; developing a habit through repetitive practice

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Learning and Memor: Declarative Learning

Requires attention, awareness,and reflection inorder to attain knowledge that cab be consciously recalled

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Study Notes

  • Topics covered include Multiple Sclerosis, Huntington's Disease, and Motor Learning
  • Discusses neurologic interventions, objectives, review, clinical features, medical management, physical therapy management, motor learning and clinical strategies

Multiple Sclerosis (MS)

  • Is a chronic debilitating disease resulting from demyelination of the nervous system.

  • Onset is typically between 20-40 years of age.

  • Females have twice the incidence compared to males.

  • Affects over 400,000 people in the U.S.

  • Higher rates are observed in the US, Canada, and Northern Europe.

  • Etiology is unknown, but viral infections and autoimmune dysfunction are implicated.

  • Having a relative with the disorder increases one's risk due to a genetic component.

  • Patches of demyelination occur in the white matter of the brain and spinal cord.

  • Cells that make myelin are also destroyed, preventing re-myelination of the axon.

  • Inflammation accompanies the destruction.

  • Myelin allows for increased speed of conduction; without it, nervous system responsiveness decreases.

  • Sensory symptoms include parasthesias ("pins and needles") and dysesthesias (abnormal burning or aching).

  • Visual symptoms include decreased acuity, neuritis (inflammation of the optic nerve causing graying or blurring), diplopia (double vision), and nystagmus (involuntary eye oscillation).

  • Motor symptoms include motor weakness in one or both legs, corticospinal tract involvement, poor balance, ataxia, postural tremor, and scanning speech (slow, long pauses, lack of fluidity).

  • Fatigue is a frequent symptom without a clear physiological reason, worsened by heat and linked to depression.

  • Uhthoff phenomenon induces blurred vision, increased paresthesias and overwhelming fatigue when overheated.

  • Cognitive impairment occurs in half of MS patients with mild to moderate severity that can affect problem-solving, short-term memory, visual-spatial perception, and conceptual reasoning and often present with emotional lability.

  • Autonomic dysfunction may lead to impaired bowel and bladder control, urinary retention, nocturia, constipation, and, in later stages, complete loss of bowel/bladder control and sexual dysfunction.

  • There are four types of MS:

  • Clinically Isolated Syndrome (CIS): First episode of neurologic symptoms lasting 24 hours that can progress to MS.

  • Relapsing-remitting: Definable exacerbations and remissions are the most common.

  • Primary-progressive: Relentless progression without relapses, accounting for 10% of cases.

  • Secondary-progressive: Starts with relapsing and remissions, then progresses with only occasional relapses.

  • Diagnosis typically involves a clinical evidence of at least two lesions in the brain, spinal cord or optic nerve with evidence that damage occurred at different times, as well as ruling out other possible diagnose.

  • Sometimes, Cerebral spinal fluid may show presence of oligoclonal bands and myelin protein.

  • 4 injectable medications (CRAB) have been developed.

  • Copaxone reduces inflammation at lesion sites and frequency of attacks.

  • Rebif, Avonex and Betaseron are Interferons Immune system modulators

  • Other symptoms treated pharmacologically include muscle spasms, spasticity, weakness, fatigue, visual and urinary symptoms, pain, and depression.

  • Cortisone/corticosteroids shorten acute attacks.

  • Dantrium and Lioresal treat spasticity.

  • Ditropan and Probanthine treat bladder urgency and frequency.

  • Klonopin treats severe tremors.

  • Provigil and Symmetrel treat fatigue.

  • Tegretol treats tonic spasms, and Valium treats night spasms.

PT Management of MS

  • Goals include minimizing progression, maintaining functional independence, preventing complications, maintaining respiratory function, conserving energy and managing fatigue, and patient/family education.
  • Strength training in moderation, spasticity and ataxia management, cardiorespiratory training, and fatigue management are used.
  • Low intensity with frequent repetitions, rest breaks, and non-fatiguing protocols are employed.
  • Exercising to the point of fatigue is generally contraindicated.
  • PNF used to be functional and reduce the spasticity.
  • Pre-cooling may consist of fans, cool pools of 80-85 degrees, or cooling suits.

Spasticity Management

  • Slow, static stretching prior to exercises can help.
  • Particular emphasis on the cervical region, hamstrings, hip flexors, adductors, and heel cords.
  • PNF techniques that are implemented hold and relax with rotation contract.
  • Self-stretching should be taught to patient and family.

Ataxia Management

  • Employs a developmental sequence.
  • PNF techniques such as alternating isometrics, slow reversals, and rhythmic stabilization.
  • Frenkel Exercises also help with this.
  • The use of weight belts/vests help to raise proprioceptive awareness and increase stability.
  • Light weights improve coordination and control.
  • Balance training can implement the use of a tilt board, baps board, ball, and balance master.
  • Gait training may use light distal weights on wrists and ankles for stability.
  • Assistive devices: SPC quad cane, FWW or 4WW with seat may be used.
  • Orthotics: AFO, as well as KAFO, and HKAFO.

Huntington's Disease (HD)

  • Progressive, inherited neurodegenerative disease that causes death of neurons in the basal ganglia.
  • It is a heredity disease that has an autosomal dominant trait that has an estimated effect of 3 to 7 per 100,000 people of european decent.
  • It is usually diagnosed between ages 35-55.
  • Movement disorder characterized by involuntary choreic movements.
  • Mild alterations in personality, grimacing, protrusion of tongue, and ataxia with choreoathetoid movements are symptoms.
  • Late stages bring mental deterioration, decreased IQ, dysphagia, incontinence, immobility, and rigidity.
  • Chroea consists of involuntary movements that affect all muscles of the body specifically arms, legs, face, and tongue.
  • FDA-approved medications to treat chorea include Tetrabenazine, deutetrabenazine and valbenazine.
  • However, medications don't affect how the disease progresses.
  • Cognitive impairments includes difficulty organizing task, perseveration and lack of impulse control.
Mental health conditions associated with HD:
  • Depression, obsessive-compulsive disorder, mania and Bipolar disorder
Other Medications that will manage emotional symptoms:
  • Antidepressants, Antipsychotic medications, and Mood-Stabilizing medications.
  • The early stage is often with a largely fully functional individual.
  • Psychological symptoms cane be prresent but are harder to recognize, especially in later stages, due to the limited communication.
  • Role of physical therapy can depend on what stage of the disease.
  • Early stage often to prevent mobility restrictions.
  • Mid stage is often to slow down progress and help maintain function.
  • Late stage: limiting impact of complications and providing supportive care.
  • PT/PTA is a key member of the interdisciplinary team.

Clinical Practice Guidelines of HD includes:

  • Aerobic exercise paired with strengthening to improve fitness and stabilize motor function
  • Gait training to improved walking speed and step length
  • Balance and breathing exercise and ADL seating and positioning may help although there is not recommendation.

PTA Considerations

  • Treatment can get in the water. PTA should be aware if the patient is getting agitated complete activities in a quite room.

Motor Control

  • It’s the ability to maintain and change postures and movement is the result of a complex set of neurologic and mechanical processes.
  • The process involves and individual using a task and the surrounding environment as a guide.
  • Stages of motor control involved mobility, stability, controlled mobility and skilled movement.

Motor Learning

  • Process that brings about permanence in motor performance over the time of practice.
  • Fitts' Stages of Motor Learning is an indicator of motor ability.
  • Types of feedback include sensory , task performance, and motor functions.
  • Influence of Practice includes Massed vs Distributed Practice and Part vs. Whole Training
  • Types of learning and memory include non-assocaited learning and declarative learning.
  • Many types of attention include sustained attention
  • Prerequites for attention are Arousal and Concentration
  • Clinical strategies includes giving feedback to stimulate learning.

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