
Multiple sclerosis (MS) is a life-long chronic disease of the central nervous system. It affects mainly young women (ages 20 to 50) and is an unpredictable condition that can range from being relatively benign to being totally disabling. Some people with MS may be mildly affected while others may lose their ability to write, speak, or walk. The problem occurs due to multiple areas of inflammation and scarring (sclerosis) in the central nervous system. When this happens, communication between the brain and other parts of the body is disrupted. About 250,000 to 350,000 people in the US have MS.
Although the cause of MS is not known, some of the causes of MS currently under investigation include the following:
viruses
environmental factors
genetic factors
Symptoms of MS are erratic and may be mild or severe. It is common to have an attack followed by a period of recovery - this is called exacerbations and remissions. Other times, symptoms are progressive and may appear in various combinations, depending on the area of the nervous system affected.
Initial symptoms of MS may include:
blurred or double vision
red-green color distortion
pain and loss of vision due to optic neuritis (inflammation of the optic nerve)
paresthesia (abnormal sensation or pain, such as numbness, prickling, or "pins and needles")
Other symptoms of multiple sclerosis may include any/all of the following (to a varying degree):
muscle weakness in the extremities
difficulty with coordination (impaired walking or standing may result; partial or complete paralysis is possible)
spasticity (increased muscle tone leading to stiffness and spasms)
loss of sensation
tremor
About 50 percent of all people with MS experience cognitive impairments related to their disease. The effects of these impairments may be mild or severe and may include difficulty with any of the following:
concentration
attention
memory
poor judgment
A rehabilitation program for people with MS is designed to meet the needs of the individual patient, depending upon the type and severity of the symptoms and the amount of impairment. Active involvement of the patient and family is vital to the success of the program.
The goal of MS rehabilitation is to help the patient to return to the highest level of function and independence possible, while improving the overall quality of life - physically, emotionally, and socially.
In order to help reach these goals, MS rehabilitation programs may include the following:
exercises and activities to help improve motor skills, restore activities of daily living (ADLs), and help the patient reach maximum independence
exercises that promote muscle strength, endurance, and control
management of bowel or bladder control
use of assistive devices such as canes, braces, walkers
methods to improve communication skills for patients who have difficulty speaking
vocational counseling
adapting the home environment for ease of function, safety, accessibility, and mobility
patient and family education
Rehabilitation programs for patients with MS can be conducted on an inpatient or outpatient basis. Many skilled professionals are part of the rehabilitation team, including any/all of the following:
physiatrist
internist and other specialists
rehabilitation nurse
physical therapist
speech/language therapist
audiologist
psychologist/psychiatrist
case manager
chaplain
vocational counselor
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