Thursday, May 23, 2013

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Rehabilitation And Functional Recovery Of Multiple Sclerosis Patients

Multiple sclerosis is a demyelinating and neurodegenerative disease of the central nervous system (cerebral hemispheres, optic nerve, brainstem, spinal cord), representing the most common cause of severe disability in young adults.

MS seems to be the disease in which the results are less satisfactory in terms of long-term evolution. Despite the medical treatment the patient's condition tends to worsen. In no other neurological disease there are not affected so many areas of the central nervous system. Rehabilitation approach involves intervention on each disturbance area occurred.

It is very important for patients to know that recovery is the only way for a patient with MS to improve his quality of life. Because for this condition, despite some small progress, there are a number of questions. They consist in determining the cause of MS, identifying and understanding the mechanisms of lesion tissue regeneration pathways to promote myelin and axons. These questions should be solved in order to control or cure MS and to make patient disability reversible.

MS Management is primarily focused on stabilizing the disease. From a practical standpoint, control of symptoms caused by the destructive remains of primary importance. This is accomplished ideally by medication and recovery. Patients with MS often come in rehabilitation services, asking help for malfunctions or disability (secondary of neurological disability or lack of activity).

Disease is difficult recoverable with a clinical picture which may include muscle weakness, spasticity (system disorder sensory-motor), loss of sensation, ataxia (inability to coordinate muscle groups during voluntary movements - movements appear vague, hesitant), dismetrie (wrong sizing movements), tremor, pain, depression, fatigue, an combination of symptoms unprecedented in another situation. Moreover, the disease can worsen over time and has unpredictable evolution, requiring periodicals reevaluations.

RECOVERY

In Multiple Sclerosis, recovery is a process that helps a person to achieve and maintain maximum physical, psychological, social and vocational potential, and to improve his/her quality of life. So MS is a disease who requires close cooperation between recovery team. There are controversy regarding the prescription of exercise in MS patients. The assumptions against this process are claiming that exercises in Ms patients will increase fatigue, the risk of relapse, core temperature, it would accelerate disease progression and would not increase muscle strength. On the other hand the arguments who are pro physical activity in MS claim that would these will improve peripheral fatigue, would fight central and coexistence mechanisms and will increase muscle strength.

METHODOLOGY medical rehabilitation
Regarding the recommended exercises for rehabilitation of patients with MS are recommended aerobic exercises, exercises to increase/maintain mobility (passive pasivo-active, active), muscle stretching, balance exercises with biofeedback platform visual/auditory exercises coordination. Also, patients shouldn't avoid to perform occupational therapy, sports therapy, hydrokinetotherapy (inaccessible for technical reasons), cognitive behavioral therapy, speech therapy, physiotherapy sphincter.

The specialist recommended that the length of recovery to be between 1-3 h/day, daily, 15 consecutive days (except weekends) in the morning. Sequence program 3 times/year, number of steps - 5. The total duration of the program for each patient should be two years.

In recent years, several drugs have been approved in the U.S. for the treatment of MS. Although these drugs are not curative, they decrease the frequency and sometimes the severity of attacks, slow neurological deterioration and at least in the short term these drugs reduce the number of lesions visible on MRI.

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