Physiotherapy Approaches in the Treatment of Ataxic Multiple Sclerosis: A Pilot Study

Objective: This study was planned to investigate the efficacy of neuromuscular rehabilitation and Johnstone Pressure Splints in the patients who had ataxic multiple sclerosis. Methods: Twenty-six outpatients with multiple sclerosis were the subjects of the study. The control group (n = 13) was given neuromuscular rehabilitation, whereas the study group (n = 13) was treated with Johnstone Pressure Splints in ad dition. Results: In pre- and posttreatment data, significant differences were found in sensation, anterior balance, gait parameters, and Expanded Disability Status Scale (p < 0.05). An important difference was observed in walking-on-two-lines data within the groups (p < 0.05). There also was a statistically significant difference in pendular movements and dysdiadakokinesia (p < 0.05). When the posttreatment values were compared, there was no significant difference between sensation, anterior balance, gait parameters, equilibrium and nonequilibrium coordination tests, Expanded Disability Status Scale, cortical onset latency, and central conduction time of somatosensory evoked potentials and motor evoked potentials (p > 0.05). Comparison of values re vealed an important difference in cortical onset-P37 peak amplitude of somatosen sory evoked potentials (right limbs) in favor of the study group (p < 0.05). Conclu sions : According to our study, it was determined that physiotherapy approaches were effective to decrease the ataxia. We conclude that the combination of suitable phys iotherapy techniques is effective multiple sclerosis rehabilitation. Key Words: Multi ple sclerosis—Ataxia—Physical therapy.

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Voice-Related Quality of Life in Patients with Multiple Sclerosis

Autoimmune Diseases ◽

10.1155/2012/143813 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Abdul Latif Hamdan ◽

Sahar Farhat ◽

Rami Saadeh ◽

Iyad El-Dahouk ◽

Abla Sibai ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Average Duration ◽

Control Group ◽

Expanded Disability Status Scale ◽

Significant Difference ◽

Disability Status ◽

Related Quality ◽

The Voice

Objective. To investigate the voice-related quality of life in a group of patients with multiple sclerosis.Participants. A total of 87 subjects (59 MS subjects and 28 controls) participated in this study.Main Outcome Measures. Variables included presence or absence of phonatory symptoms, duration of the disease, the expanded disability status scale (EDSS), the severity of fatigue, and depression. All patients were asked to fill the Voice Handicap Index.Results. The average age was 35.47 years + 10.92 with 39% being males. The average duration of the disease was 77.93 months. The EDSS score was 1.94 + 1.84, the FSS score was 4.07 + 2.09, and the HRSD was 7.28 + 7.70. Only 7 subjects out of the 59 had vocal symptoms compared to 3 in the control group. There was no significant difference in the VHI total score between cases (5.9 + 15.5) and controls (5.4 + 8.2). There was a positive correlation between VHI total score, FSS score, and HRSD (Pvalues of 0.011 and <0.01.Conclusion. The voice-related quality of life in MS is within normal with no disability.

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Relationship between Expanded Disability Status Scale scores and the presence of temporomandibular disorders in patients with multiple sclerosis

European Journal of Dentistry ◽

10.4103/ejd.ejd_91_17 ◽

2018 ◽

Vol 12 (01) ◽

pp. 144-148 ◽

Cited By ~ 2

Author(s):

Lucas Senra Correa Carvalho ◽

Osvaldo José Moreira Nascimento ◽

Luciane Lacerda Franco Rocha Rodrigues ◽

Andre Palma Da Cunha Matta

Keyword(s):

Multiple Sclerosis ◽

Temporomandibular Disorders ◽

Control Group ◽

Expanded Disability Status Scale ◽

Exact Test ◽

Disability Status ◽

Relapsing Remitting ◽

Scale Scores ◽

Axis I ◽

Relapsing Remitting Multiple Sclerosis

ABSTRACTObjectives: The objectives of this study were to assess the prevalence of temporomandibular disorders (TMDs) in patients with relapsing-remitting multiple sclerosis (MS) and to investigate whether an association exists between the presence of TMD symptoms and the degree of MS-related disability. Materials and Methods: In all, 120 individuals were evaluated: 60 patients with a diagnosis of relapsing-remitting MS and 60 age- and sex-matched controls without neurological impairments. A questionnaire recommended by the European Academy of Craniomandibular Disorders for the assessment of TMD symptoms was administered. For those who answered affirmatively to at least one of the questions, the RDC/TMD Axis I instrument was used for a possible classification of TMD subtypes. The Expanded Disability Status Scale (EDSS) was the measure of the degree of MS-related disability. Statistical Analysis Used: Fisher’s exact test was used to analyze the data. ANOVA was used to detect significant differences between means and to assess whether the factors influenced any of the dependent variables by comparing means from the different groups. Results: The prevalence of TMD symptoms in patients with MS was 61.7% versus 18.3% in the control group (CG). A diagnosis of TMD was established for 36.7% in the MS group and 3.3% in the CG (P = 0.0001). There were statistically significant differences between degrees of MS-related disability and the prevalence of TMD (P = 0.0288). Conclusions: The prevalence of both TMD and TMD symptoms was significantly greater in the MS group. EDSS scores and TMD prevalence rates were inversely related.

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Restless Leg Syndrome in Patients with Multiple Sclerosis and its Effect on Frequency of Daytime Sleepiness and Fatigue of the Patients

Galen Medical Journal ◽

10.31661/gmj.v5i1.422 ◽

2016 ◽

Vol 5 (1) ◽

pp. 7-12

Author(s):

Nahid Ashjazadeh ◽

Zahra Shamszadeh

Keyword(s):

Multiple Sclerosis ◽

Daytime Sleepiness ◽

Study Group ◽

Expanded Disability Status Scale ◽

Restless Leg Syndrome ◽

Severity Scale ◽

Medical Sciences ◽

Disability Status ◽

Fatigue Severity ◽

Study Participants

Background: Restless leg syndrome (RLS), fatigue and daytime sleepiness are three known co-morbidities in patients with multiple sclerosis (MS). The aim of this study was to evaluate the frequency of RLS in patients with MS and its effect on the frequency of fatigue and daytime sleepiness in these patients. Material and Methods: One hundred twenty patients who referred to the Inpatients Neurology Ward of Chamran hospital, affiliated with the Shiraz University of Medical Sciences, from June 2014 to March 2015, were selected as the study participants. The patients with clinically definite MS, according to the 2010 Revised Mc-Donald criteria, and expanded disability status scale (EDSS) ≤5.5 were included. RLS, fatigue and daytime sleepiness were assessed by the criteria of the International RLS study group (IRLSSG), fatigue severity scale (FSS) and Epworth sleepiness scale (ESS) respectively and the related statistical analyzes were conducted. Results: Seventy eight patients (65%) met all the four IRLSSG criteria, 77 patients (64.1%) suffered from fatigue and only 36 patients (30%) had excessive daytime sleepiness. RLS was not significantly linked to mean age, sex, MS duration, and daytime sleepiness of the studied MS patients, but fatigue was more frequent in MS patients with RLS, which was statistically significant (P=0.018). Conclusion: The main result of this study is that RLS is a common comorbidity in MS and the patients with MS, who also suffer from RLS. They have frequently experienced higher fatigue symptoms than those without RLS. Therefore, the appropriate diagnosis and management of RLS may improve both RLS and fatigue in these patients. [GMJ. 2016;5(1):7-12]

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Long latency auditory evokedpotentials in malnourished children

CoDAS ◽

10.1590/s2317-1782201300050000 ◽

2013 ◽

Vol 25 (5) ◽

pp. 407-412 ◽

Cited By ~ 7

Author(s):

Renata Parente de Almeida ◽

Carla Gentile Matas

Keyword(s):

Evoked Potentials ◽

Auditory Evoked Potentials ◽

Impedance Measurement ◽

Pure Tone Audiometry ◽

Control Group ◽

Study Group ◽

Malnourished Children ◽

Long Latency ◽

Significant Difference ◽

The Right

PURPOSE: To characterize the findings obtained in the long latency auditory evoked potentials in malnourished children, as well as to compare them to the results obtained for children at the same age who present typical development. METHODS: Sixty-five children aged between 7 and 12 years old, of both genders, were evaluated. The control group consisted of 34 children with normal development and the study group consisted of 31 children diagnosed with malnutrition. All children underwent conventional pure tone audiometry, acoustic impedance measurement, dichotic digit test and long latency auditory evoked potentials. RESULTS: The study group presented a statistically significant difference for latencies of the components P1, N1 and P300. The latencies of these components were higher than those of the control group. Concerning the types of alterations found in the study group, increased latency for P1 and P300 and the absence of response in N1 were predominant. The control group showed a statistically significant difference in the amplitude of P300 when compared to the right and left ears. CONCLUSION: Malnourished children present with changes in the long latency auditory evoked potentials, suggesting a deficit in central auditory pathways and alterations in the processing of acoustic information.

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Cerebral Evoked Potentials in Multiple Sclerosis

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100036349 ◽

1986 ◽

Vol 13 (3) ◽

pp. 240-244 ◽

Cited By ~ 5

Author(s):

Manouchehr Javidan ◽

Donald R. McLean ◽

Kenneth G. Warren

Keyword(s):

Multiple Sclerosis ◽

Evoked Potentials ◽

Diagnostic Yield ◽

Objective Measure ◽

Control Group ◽

Conduction Time ◽

Auditory Evoked Responses ◽

Cerebral Evoked Potentials ◽

Sensory Evoked Potentials ◽

Sensory Evoked

ABSTRACT:Multimodal evoked potentials were analyzed from 58 possible, 62 probable and 100 definite (total 220) multiple sclerosis (MS) patients. Visual evoked potentials (VEP) were most frequently abnormal yielding 39%, 69%, 84% in the three diagnostic groups respectively. Median nerve sensory evoked potentials (SEP) yielded abnormalities in 26%, 65%, 79% respectively. Brainstem auditory evoked responses (BAER) were abnormal in 17%, 39%, 66% respectively. We measured the combined amplitude (CA) of waves III, IV, V in the BAER of these patients as an objective measure of amplitude asymmetry. The CA was considered abnormal if it was 1SD below the lowest CA value in the control group. The CA was abnormal in 9.2% of BAER with normal central conduction time. The BAER diagnostic yield in MS patients increased 11% by using CA analysis.

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Motor evoked potentials in clinically isolated syndrome suggestive of multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458508099612 ◽

2009 ◽

Vol 15 (3) ◽

pp. 355-362 ◽

Cited By ~ 17

Author(s):

A Rico ◽

B Audoin ◽

J Franques ◽

A Eusebio ◽

F Reuter ◽

...

Keyword(s):

Multiple Sclerosis ◽

Evoked Potentials ◽

Amplitude Ratio ◽

Motor Evoked Potentials ◽

Clinically Isolated Syndrome ◽

Conduction Time ◽

Motor Pathway ◽

Clinical Sensitivity ◽

Conduction Failure ◽

Stimulation Technique

The aim of the present study was to determine the sensitivity and the profile of motor evoked potentials (MEP) in patients with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS). We measured the central motor conduction time (CMCT), amplitude ratio (AR), and surface ratio (SR) in tibialis anterior and first dorsal interosseous muscles in 22 patients with CIS. In 12 patients, the triple stimulation technique (TST) was also performed. AR was abnormal in 50% of patients, CMCT in 18% of patients, and TST in 25% of patients. AR had the highest sub-clinical sensitivity and the best positive predictive value. In the absence of clinical pyramidal signs, an early AR decrease seems to result from demyelination inducing excessive temporal dispersion of the MEP, while in territories with clinical pyramidal signs, it seems to result from conduction failure, which suggests that clinical pyramidal signs may be attributable to conduction failure. This study demonstrates that MEP, especially the AR, is sensitive to motor pathway dysfunction right from the early stages of MS.

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Three-Day Dietary Manipulation in Multiple Sclerosis: Exercise and Fatigue Outcomes

International Journal of MS Care ◽

10.7224/1537-2073.2020-036 ◽

2021 ◽

Author(s):

Lacey E. Bromley ◽

Peter J. Horvath ◽

Susan E. Bennett ◽

Bianca Weinstock-Guttman ◽

Todd C. Rideout ◽

...

Keyword(s):

Multiple Sclerosis ◽

Exercise Performance ◽

Submaximal Exercise ◽

Peak Oxygen Consumption ◽

Control Group ◽

Dietary Manipulation ◽

Expanded Disability Status Scale ◽

Randomized Controlled ◽

Disability Status ◽

Improve Fatigue

Abstract Background: In persons with multiple sclerosis (MS), the effect of nutrition on exercise performance and fatigue remains unknown. The objective was to determine whether a 3-day diet high in triglycerides (FAT) compared with a 3-day diet high in carbohydrates (CARB) would improve fatigue and exercise performance in persons with MS. Methods: A randomized controlled crossover design was incorporated to study FAT versus CARB on submaximal cycling endurance (60% of peak oxygen consumption), substrate utilization, and fatigue in 12 persons with mild-to-moderate MS (Expanded Disability Status Scale score, 2.0–5.0) and 12 age- and sex-matched controls. Results: There were no differences in cycling time between diets in either group (P = .29). The MS group had no changes in fatigue between diets (P = .64); the control group demonstrated increased total mental fatigue after FAT (P = .05). The control group increased carbohydrate oxidation by 24% at rest and 13% during exercise after CARB. Similarly, the control group significantly increased fat oxidation after FAT by 22% at rest and 68% during exercise (P = .01). These changes were not seen in the MS group. Compared with controls, persons with MS oxidized approximately 50% less fat during exercise after FAT (P = .05). Conclusions: Neither CARB nor FAT altered submaximal exercise performance or baseline fatigue in the MS group. The results suggest that persons with MS are unable to adapt to dietary changes and oxidize fatty acids as efficiently as controls.

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Role of Mobile Technology in Multiple Sclerosis Patients' Health Education

QJM ◽

10.1093/qjmed/hcab102.021 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Muhammad Badr Ahmed ◽

Maged Zakaria ◽

Dina Zamzam ◽

Tamer H Emara

Keyword(s):

Multiple Sclerosis ◽

Health Education ◽

Medical Treatment ◽

Mobile Health ◽

Control Group ◽

Study Group ◽

Active Case ◽

Significant Difference ◽

Multiple Sclerosis Patients ◽

Arabic Speaking

ABSTRACT Background Many African and Asian randomized clinical trials stated that mobile health technology is helpful in health education and improvement of patients' compliance to medical treatment especially in chronic diseases like hypertension, diabetes mellitus and obesity. Objectives Mobile health applications can provide a health education method for MS patients and a tool for assessment of patients' compliance to medical treatment among MS patients of the Arabic speaking population. Patients and method Type of Study: Prospective comparative observational study, tool: android MS world App, study setting: arabic speaking communities, study duration: six months, study population: multiple sclerosis patients, sampling method: random, sample size 100 patients, 50 study group using the app, 50 control group non app users. Results In the present study, we revealed that total number of patients on the app of the studied group, 60(51.72%) were male and 56(46.28%) were female, and as regard number of active patients on the app of the studied groups, we found that 19(40.43%) were male and 28(59.57%) were female with 3cases dropped out. We analyzed patients in different Egyptian governments of the studied group, Most of our cases were from Cairo 66(69.47%), 9(9.47%) from Giza, 4(4.21%) from Damietta, 2(2.11%) from Alexandria, 2(2.11%) from Gharbia, 2(2.11%) from Qalyoubia, 2(2.11%) from Suez and 6(6.32%) from Upper Egypt. Regarding age characteristics of the studied group most of our cases in active case group and control group their age was ranged between 21—40 years 25(53.19%) and 27(54%) respectively there was statistically significant difference between study group where P < 0.001. Regarding duration since diagnosis of the studied groups, the present study demonstrated that most of cases in active case group and control group their duration since diagnosis was ranged between 1—5 years 30(63.83%) and 31(62%) respectively, and there was no statistically significant difference between study groups where P = 0.949. Regarding the MS world Application questions, we found that61.70%of studied cases find that the app easy and simple touse,87.23% that app present the information in easy and simple way, 89.36% find that app provide with satisfying answers about MS, 95.74% were confident about information presented in that app, 93.62% find that app increase the knowledge about the drugs are taking for MS and 74.47% reported that app made them not to miss taking their drugs doses regularly. On the other hand, we found that 63.83% of cases saw that app help them overcome the usual fatigue symptoms they used to have with MS, 89.36% of cases saw that doctors in the app are good, 93.62% will use that app again and 95.74% will suggest that app for friends and that app also a tool for storing information about the patient making the doctor able to take a decision and cope with the patient condition. We have found that patients are easy to get answer embarrassing questions like that asking about their sexual condition and satisfaction after being diagnosed with multiple sclerosis the results of the questionnaire revealed that about 19 (40.43%) patients aren’t satisfied while the rest of patients in the active case study group 28 (59.57%) patients reported they are satisfied meaning that all patients in the active group answered the question in contrast to the control group asked through paper questionnaire the results revealed that 23 patients reported they are not satisfied and about 15 patients reported they are satisfied about it meaning that not patients in the control group answered the question with 12 patients didn’t answer the question that could add the advantage of mobile health apps in recording easily embarrassing questions rather than conventional methods. Conclusion Mobile health applications can provide a health education method for MS patients and a tool for assessment of patients' compliance to medical treatment among MS patients of the Arabic speaking population.

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Serum Anjiogenesis Factors of Neuropilin-1 and Neuropilin-2 Levels in Clinically Isolated Syndrome and Relapsing-Remitting Multiple Sclerosis Patients

10.21203/rs.3.rs-67589/v1 ◽

2020 ◽

Author(s):

Ahmet Dönder ◽

Hasan Hüseyin ÖZDEMİR ◽

Hamza ASLANHAN

Keyword(s):

Multiple Sclerosis ◽

Clinically Isolated Syndrome ◽

Control Group ◽

Expanded Disability Status Scale ◽

Angiogenesis Factors ◽

Neuropilin 1 ◽

Disability Status ◽

Relapsing Remitting ◽

Remitting Multiple Sclerosis ◽

Relapsing Remitting Multiple Sclerosis

Abstract Background: Several of the molecular constituent factors in the pathophysiology of Multiple Sclerosis (MS). Neuropilins are transmembrane glycoproteins which have to be receptors for the vascular endothelial growth factor (VEGF) family of angiogenesis factors. The role of angiogenesis factors of Neuropilin-1 and 2 in the pathology of MS is unknown. Methods: We aimed to investigate levels of serum Neuropilin-1 and 2 in Relapsing-Remitting Multiple Sclerosis (RRMS), and Clinically Isolated Syndrome Patients (CIS) and to investigate a correlation with, age, sex, Expanded Disability Status Scale (EDSS) and relationship with immunomodulatory therapy. Serum Neuropilin-1 and 2 concentrations of 46 RRMS patients and 28 CIS patients and 45 healthy control group were analyzed. Clinical status was evaulated using the Expanded Disability Status Scale (EDSS). Results: Neuropilin-1 and 2 concentrations matched for immumodulatuar treatment, age and sex at a group level.Neuropilin levels were found to be significantly higher in the CIS and RRMS patient’s groups compared with the control group (p˂0,001). No statistically significant difference was found between groups; age, immunmodulatuar treatment, EDSS and gender. Conclusions: Neuropilin-1 and 2 levels have been shown to increase in RRMS and CIS patients. Neuropilins, one of the factors of angiogenesis, may be effective in pathophysiology since the first period of the disease.

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Assessment of motor outcomes in multiple sclerosis patients with walking impairment treated with Fampridine using motor evoked potentials

10.21203/rs.2.14103/v1 ◽

2019 ◽

Author(s):

DANIELA MARILENA TROFIN ◽

DAN TROFIN ◽

BOGDAN IGNAT ◽

ANDREI CIOBICA ◽

TEODOR STAMATE ◽

...

Keyword(s):

Multiple Sclerosis ◽

Clinical Improvement ◽

Motor Evoked Potentials ◽

False Negative ◽

Conduction Time ◽

Disability Status ◽

Clinical Benefits ◽

Electrophysiological Findings ◽

Multiple Sclerosis Patients ◽

Motor Outcomes

Abstract Backgound : the purpose of the study is to consider the utility of Transcranial Magnetic Stimulation (TMS) in patients with Multiple Sclerosis (MS) and walking impairment, treated with Fampridine, as correlated with the 25-Foot-Walk test (T25-FW). It is known that clinical benefits should be identified within two to four weeks after starting the treatment; otherwise, if there is no benefit reported by patients, it should be discontinued. Methods: 15 MS patients with walking impairment, ranked between 3.5 and 7 on the Expanded Disability Status Scale (EDSS), were investigated by T25-FW and TMS. Evaluations were performed prior to Fampridine 10 mg twice daily administration, 5 and 12 days afterwards, and also 1 and 3 months later. The medium age was 42.8 years and an average duration of the disease was 12.06 years. Results: we assessed an improvement of walking by 2.1 seconds measured on the T25-FW after the first 12 days in 9 patients, which correlated with a 2 miliseconds improvement of the Central Motor Conduction Time (CMCT). For the other 6 patients there was no visible clinical improvement. Nevertheless, CMCT dropped by 0.5 ms and the motor conduction speed by 1 millisecond in 4 of these 6 patients. Fampridine administration was continued in the 4 cases. At the end of the 3 months period, their walking speed measured as on the T25-FW also improved by 2 sec. Conclusions: the amelioration of TMS parameters anticipated the improvement of speed on the T25-FW. In spite of the early false negative clinical response, electrophysiological findings could predict a future clinical improvement if treatment is continued.

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