Physiotherapy management of Multiple sclerosis
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This document provides an overview of the physical therapy management of multiple sclerosis. It discusses assessing patients through examinations of vital signs, cognition, sensation, motor function, posture, balance, gait, locomotion, aerobic capacity, and functional independence. Short term goals include minimizing progression, preventing complications, and maintaining respiratory and functional abilities while long term goals focus on decreasing spasticity and improving strength, range of motion, balance, and activities of daily living. Management techniques for weaknesses, spasticity, ataxia, fatigue, locomotion, and swallowing are outlined, including exercises, stretches, electrical stimulation, and energy conservation methods.
Physiotherapy management of Multiple sclerosis
- 1. PT MANAGEM ENT OF MULTI PLE SCLEROSIS KEERTHI PRIYA MPT NEURO, ASSISTANT PROFESSOR
- 3. ASSESSMENT Demographic data Chief complaints History Pain assessment :Mc Gill Pain Questionnaire , Neuropathic Pain Scale
- 4. ASSESSMENT Observation : Involuntary movements: eye balls, upper & lower limbs Posture; abnormal posturing Gait: abnormalities (may be ataxic) Limb attitude: abnormal attitude (synergies) Abnormal Respiratory pattern Locomotion Skin integrity
- 6. ASSESSMENT EXAMINATION: Cognitive: MMSE Minimal Examination Of Cognitive Function In Multiple Sclerosis Emotional: Beck Depression Inventory
- 7. ASSESSMENT EXAMINATION: Cranial Nerves: 2, 3,4,5,6,8,9,10 & 12, absence of Gag Reflex Sensory : superficial Deep sensation in QOL by Nottingham sensory assessment
- 8. ASSESSMENT EXAMINATION: Motor : Tone : MASS Power: MMT, Dynamometer DTR ROM Amended Motor Club Examination For Motor & Functional Deficits In Multiple Sclerosis
- 9. ASSESSMENT POSTURE: sitting standing • Plumb line • Still photography with light emitting diode
- 10. ASSESSMENT BALANCE: BBS POMA GAIT: step length & stride length cadence 6 minute walk test Dynamic gait index
- 11. ASSESSMENT LOCOMOTION: Usage Dependency Shifting AEROBIC CAPACITY: Dyspnea Scale Borg Rating Of Perceived External Scale
- 12. ASSESSMENT FUNCTION: FIM Barthel Index Disease specified scales: Expanded Disability Status Scale Multiple Sclerosis Impact Scale FATIGUE scales: Modified Fatigue Impact Scale
- 13. GOALS SHORTTERM 1. Minimize progress 2. Prevent/ decrease complications 3. Maintain respiratory function 4. Manage fatigue 5. Maintain optimal level of functional impedance LONG TERM 1. To decrease spasticity 2. To increase muscle strength 3. To increase ROM 4. To improve balance 5. To improve ADL
- 14. MANAGEMENT WEAKNESS: 1. Prescribe exercise based on FITS principle 2. Low to moderate exercise 3. Resistance exercise by ISOKINETIC device, Pulley,Therabands,UnderWater 4. PNF to improve functional rotation component 5. Strengthen proximal musculature to decrease fatigue
- 15. MANAGEMENT SPASTICITY: 1. cryo stretches 2. Self stretches 3. PNF hold relax 4. Stretching inlying & sitting 5. Rotation exercise of pelvic girdle 6. ROM exercise to increase flexibility
- 17. Rotation exercise of pelvic girdle
- 18. MANAGEMENT ATAXIA: 1. Weight bearing 2. PNF: ISOMETRICS, rhythmic stabilisation, slow reversals 3. Weight belts, vest exercises 4. Frankel’s exercise 5. Biofeed back
- 19. MANAGEMENT FATIGUE: 1. Energy conservation technique 2. Change of task 3. Change of environment
- 20. MANAGEMENT LOCOMOTION : 1. Treadmill training 2. RATT(ROBOT ASSIATEDTREADMILTRAINING) 3. BODYWEIGHT SUPPORTEDTREADMILTRAINING 4. FES(FUNCTIONAL ELECTRICAL STIMULATION)
- 21. MANAGEMENT SWALLOWING : 1. Tracheal stimulation 2. Thermal tactile stimulation 3. Oropharyngeal exercises
- 22. REFERENCES • PHYSICAL REHABILITATION BY SUSSAN O SULLIVAN • NEUROLOGICAL INTERVENTIONS FOR PHYSIOTHERAPY BY MARTIN