Understanding Multiple Sclerosis Symptoms

Multiple Sclerosis Presentation

• Topic: Multiple Sclerosis (MS)
• Presenters: Carissa, Emily, Kiara, and Reese
• Date: November 26, 2024
• Course: HKIN 453

Presentation Outline

• General Overview
• Symptoms
• Etiology
• Types of MS
• Case Study
• Other Characteristics
• General Condition Management
• Exercise Response and Goals
• ICF Model Overview
• Medications
• Exercise Program
• References

General Overview

• MS is a central nervous system disease
• It disrupts brain and body connections
• The immune system attacks the myelin sheath
• This damage disrupts signals traveling between the brain and spinal cord
• Leads to various affected areas (vision, brain, spinal cord, mouth and speech, senses, digestive system, muscles, and urinary system)

Symptoms

• Numbness
• Tingling
• Mood changes
• Cognitive impairment
• Memory problems
• Fatigue
• Blindness
• Muscle weakness
• Coordination difficulties
• Bladder/bowel problems
• Pain
• Symptoms vary

Etiology & Incidence

• Age: Age is a factor
• Sex: Gender is a factor
• Race: Racial background is a factor
• Genetics: Genetic factors play a role
• Low Vitamin D Level: Low vitamin D levels impact risk
• Geography/Climate: Location relative to the equator is involved
• Obesity: Obesity increases susceptibility by 50%
• Smoking: Smoking also increases susceptibility by 50%

Types of MS

• Attack/Relapse: The appearance of new symptoms, or the return of old symptoms, for a period of 24 hours or more. Symptoms can last for weeks or months, usually resolving within a month.
• Benign MS: No disability, returns to normal between attacks.
• Relapsing-remitting MS (RRMS): Never new disability between attacks
• Secondary Progressive MS (SPMS): No new disability between attacks followed by steady increase in disability
• Primary Progressive MS (PPMS): Steady increase in disability without attacks

Case Study: Mary

• Age 38
• Canadian
• Relapsing-remitting MS (RRMS)

Where Does Mary Fit In?

• Prevalence: 90,000/2.8 million
• Frequency: 12 per day in Canada
• Demographic: 47% are female; 43 years old; 75% located north of the equator

ICF Model Overview

• Health Condition: Multiple Sclerosis
• Body Functions/Body Structures: Blurred vision, numbness, tingling, difficulty walking, taking transit, Balance, Gait (walking & stair), Muscular strength.
• Activities: Taking transit.
• Participation: Balance, Gait (walking & stair), and Muscular strength.
• Environmental Factors: Weather, Accessibility of transit, Temperature, Flare-ups (low vision & low balance; overheating; side effects from medication)
• Personal Factors: None explicitly mentioned

Mary's Symptoms

• Optic Neuritis: About half of MS patients experience this inflammation of the optic nerve. This can cause blurry vision, 'washed out' colour vision and eye pain for several days.
• Partial Transverse Myelitis: Inflammation of the spinal cord, frequently resulting in numbness, tingling, and weakness in the extremities; bladder/bowel dysfunction and/or difficulty walking

Other Characteristics (Physical, Mental, Emotional, Social)

• Anxiety about symptoms and flare-ups
• Overarching anxiety about relapsing/remitting
• Depression about inability to do things
• Lifestyle adjustments to minimize symptoms
• Difficulties with employment

General Condition Management

• Effective strategies can modify or slow the disease course; treat relapses; manage symptoms; improve function; and support emotional health.
• Mental and physical well-being important

Effects of MS on Exercise Response

• Historically, physical activity is discouraged, causing more weakness and fatigue over time. However, physical activity demonstrates considerable benefits.
• Cardiovascular response to exercise is typical
• Exacerbation of symptoms (elevated spasticity, paraesthesia, vertigo) may impact exercise response
• Overheating (Uhthoff's phenomenon) and worsening of visual and neurological function; worsening of sensory-motor problems; difficulty pedalling

Exercise Goals for Management of MS

• Maintain/minimize loss of muscle strength; bone density; flexibility; cognitive function; respiratory function; mobility; balance, and coordination.
• Improve energy levels; mood

Mary's Exercise Goals

• Balance
• Gait (walking ability/mobility)
• Levels of fatigue
• Muscle strength

Common Medications and Side Effects

• Interferon Beta-1a (Avonex etc.): Slows progression of disability, reduces frequency of attacks
• Interferon Beta-1b (Betaseron): Slows progression of disability, reduces frequency of attacks
• Glatiramer Acetate (Copaxone, Glatect): Decreases frequency of MS attacks, reduces active brain lesions
• Side Effects: Vary, including flu-like symptoms, pain, injection site reactions

Mary's Medications

• Glatiramer Acetate: Every other day; 250 mcg in diluting solution via pre-filled self-injection.

Effects of Exercise Training on Condition

• Aerobic fitness; Muscle strength; Flexibility; Stability; Fatigue/energy levels; Cognition; Quality of life; Respiratory function; Bone density; Bladder and bowel function; Mood

Primary Research Articles

• Studies show that fatigue, mood, and quality of life improve in MS patients after progressive resistance training
• Studies explore the effectiveness of different exercise therapies, including yoga, aquatic exercise, etc., for improving balance and functional walking ability in MS patients.

Recommendations for Exercise Programming

• Safety Considerations: Adapt exercises to avoid fatigue, overheating, and pain. Work with a physical therapist, and quit if necessary.
• Beneficial Exercises: Include yoga poses (example photos); various exercise programs with varying levels of intensity (examples provided)
• Equipment: Consider cooling packs, grab bars, and body-weight supported treadmills
• Environmental Considerations: Manage temperature; adequate lighting; clear walking areas.
• Communication: Understand potential symptom worsening, and take it slow to avoid exercise-related fatigue.

Program Example: Mary's Hypothetical Exercise Plan

• Weekly schedule for exercise; lower-body resistance training; yoga; aquatic fitness

Case Study Overview

• Mary's MS will progress; her goals are practical; she'll exercise whenever possible; she'll take medication to slow progression.

This quiz explores key aspects of Multiple Sclerosis, including symptoms, exercise responses, and psychological effects associated with the condition. Test your knowledge on how this disease affects individuals and what factors can exacerbate its symptoms.