Anti-spasticity medication and multiple sclerosis: why nurses and therapists need to get involved

2021 ◽  
Vol 17 (Sup3) ◽  
pp. S14-S17
Author(s):  
Wendy Hendrie ◽  
Rachel Dorsey-Campbell
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Side Effects ◽  
Health Professionals ◽  
Daily Living ◽  
Treatment Plan ◽  
Active Role ◽  
Therapeutic Interventions ◽  
Medication Misuse

Spasticity is common in people with MS and can negatively affect activities of daily living and quality of life. It can be managed with anti-spasticity medications, but prescribers often fail to titrate, monitor or review the efficacy of these drugs. Optimal doses are not always reached, and insidious side effects can cause symptoms that mimic disease progression, increase disability and hinder therapeutic interventions. It is important that health professionals involved in the management of people with MS are aware of the injurious potential of these medications and educate people with MS to self-manage them. This article looks at common anti-spasticity medications, the mode of action, dosage and side effects. It provides examples of how medication misuse can lead to increased disability and explains how neurological nurses and physiotherapists can play an active role in monitoring these medications as part of their treatment plan, including information on becoming an independent or supplementary prescriber.

Symptomatic Treatment in Multiple Sclerosis

US Neurology ◽  
2013 ◽  
Vol 09 (01) ◽  
pp. 35
Author(s):  
Sandra Bigi ◽  
E Ann Yeh ◽  
◽  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Young Adults ◽  
Sexual Dysfunction ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Negative Impact ◽  
Treatment Options ◽  
Symptomatic Treatment

Multiple sclerosis (MS) is a progressive and disabling neurodegenerative disease that primarily affects young adults. Despite significant therapeutic advances in the prevention of relapses, individuals with MS experience a variety of symptoms, most notably fatigue, spasticity, depression, gait and balance difficulties, and sexual dysfunction. These symptoms may interfere with activities of daily living and have a negative impact on quality of life. This review discusses treatment options for these symptoms.

scholarly journals The Influence of Self-Perception on Manipulative Dexterity in Adults with Multiple Sclerosis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Rosa M. Martínez-Piédrola ◽  
Cristina García-Bravo ◽  
Elisabet Huertas-Hoyas ◽  
Patricia Sánchez-Herrera Baeza ◽  
Jorge Pérez-Corrales ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Daily Living ◽  
Negative Impact ◽  
Leisure Activities ◽  
Cross Sectional Study ◽  
Self Perception ◽  
Cross Sectional ◽  
Perceived Quality Of Life

Background. Multiple sclerosis is a disorder which causes a loss of functionality, affecting the person’s ability to perform activities of daily living, such as interpersonal interactions and relationship, dressing, self-care, or bathing, as well as having a negative impact on work and leisure activities. Aims. This study examined the relationship (correlational or associations/predictive) between self-perceived quality of life and performance of manipulative dexterity. Also, this study sought to measure predictors of dexterity. Study Design. A cross-sectional study from two associations of MS within the Community of Madrid, Spain. Methods and Procedures. A final sample of 30 people with multiple sclerosis. The outcome measures used were the ABILHAND questionnaire, the Purdue Pegboard Test, the Nine Hole Peg Test, and the Box and Block Test. Results. No significant correlations were found between dexterity and self-perception tests; however, correlations were found between perceived dexterity and quality of life ( p < 0.001 ). Scores for the ABILHAND questionnaire, which measures the perception of skills in daily living, predicted up to 60% of the variance in the dexterity tests. Conclusions. The results of this study suggest that interventions for improving the manipulative dexterity of people with multiple sclerosis should address the person’s perception of improving their manipulative dexterity and the perceived of quality of life, as both factors may influence manipulative dexterity.

Failure of long-term nerve root stimulation to improve neuropathic pain

2008 ◽  
Vol 108 (5) ◽  
pp. 921-925 ◽  
Author(s):  
Ralf Weigel ◽  
Hans-Holger Capelle ◽  
Joachim K. Krauss
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Side Effects ◽  
Nerve Root ◽  
Daily Living ◽  
Short Term ◽  
Test Stimulation ◽  
Root Stimulation

Object Stimulation of dorsal nerve roots or dorsal root ganglia was reported to alleviate neuropathic pain in selected patients during the early postoperative period. A prospective study was initiated to investigate long-term outcome in patients with neuropathic pain of the lower extremities or groin who were treated with selective nerve root stimulation. Methods The study included patients with dermatomally distributed neuropathic pain who were > 18 years of age and in whom the pain was refractory to medical treatment. The patients were prospectively evaluated using a visual analog scale (VAS) for pain and ratings for quality of life, activities of daily living, and depression preoperatively, and after defined intervals postoperatively. Implantation of electrodes was performed via foraminotomy or interlaminar fenestration in an awake procedure. An implantable pulse generator (IPG) was implanted in a second operation after successful test stimulation performed over several days. Results Three patients were included in the study before it was stopped. The mean maximum pain score preoperatively was 9.3. All patients had successful test stimulation with > 50% pain relief prior to implantation of the IPG (mean maximum VAS Score 3.6). The beneficial effect, however, was lost within the next few months despite adjustment of stimulation settings. With higher amplitudes, side effects such as pain attacks or motor phenomena occurred. They disappeared after stopping stimulation, but neuropathic pain recurred to its full extent. The study was stopped 18 months after the first implantation, when the third and last IPG of this series was explanted. Due to the overall short-term effect of stimulation, no relevant changes in ratings for quality of life, activities of daily living, or depression were detected. Conclusions Spinal nerve root stimulation proved to be effective on short-term follow-up in 3 patients with neuropathic pain in a dermatomal distribution. Long-term stimulation, however, was disappointing because of the loss of effectiveness and the occurrence of side effects.

The reliability and validity of the Nottingham Extended Activities of Daily Living Scale in patients with multiple sclerosis

2002 ◽  
Vol 8 (5) ◽  
pp. 372-376 ◽  
Author(s):  
C R Nicholl ◽  
N B Lincoln ◽  
E D Playford
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Controlled Trial ◽  
Reliability And Validity ◽  
Quality Of Life Scale ◽  
Assessment And Treatment ◽  
Life Scale

Objective: To investigate whether the Nottingham Extended Activities of Daily Living Scale (EADL) is reliable and valid for the assessment of disability in patients with multiple sclerosis (MS). Design: Questionnaire measures were administered on two occasions four months apart. Subjects: A total of 240 patients recruited through a randomized controlled trial of cognitive assessment and treatment in MS. Measures: The Nottingham EADL, Guys Neurological Disability Scale (GNDS) and SF-36 quality of life scale. Results: The EADL items did not form a Guttman Scale (CR 0.8, CS 0.3). The EADL and its four subscales all had high internal consistency (α 0.72-0.94). Test-retest reliability was satisfactory (rs 0.81-0.90) with a mean difference in scores on the two occasions of 0.29. Factor analysis generally supported the subscale structure. There were significant but weak correlations with quality of life measures. Conclusions: The EADL shows promise for the assessment of disability in MS, but the range of items needs to be extended. Further evaluation of the scale seems warranted.

scholarly journals Focusing on the Efficacy of Tizanidine in the Multiple Sclerosis Clinic

2001 ◽  
Vol 3 (1) ◽  
pp. 29-31
Author(s):  
Thomas F. Scott
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cerebrovascular Disease ◽  
Daily Living ◽  
Cord Injury ◽  
Improved Function ◽  
The Impact

ABSTRACT The use of tizanidine is well established in spasticity due to multiple sclerosis (MS), spinal cord injury, and cerebrovascular disease. Refinement of the use oftizanidine in these areas is ongoing. To date, most large studies have focused primarily on measurement of changes in abnormalities of tone and spasm frequency rather than changes related to improved function. More detailed studies may help to better elucidate the impact of tizanidine and other spasticity treatments on activities of daily living and overall quality of life of MS patients. (Int J MS Care. 2001; 3(1): 29–31)

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