Multiple Sclerosis In Order Research Articles

The Effect of Acupressure Applied to Patients With Multiple Sclerosis on Fatigue.

This study was conducted in order to examine the effect of acupressure applied to patients with multiple sclerosis on fatigue. The patients meeting the inclusion criteria were assigned to intervention (n = 30) and control (n = 30) groups. The data of the study were collected using a questionnaire and the Fatigue Severity Scale. During the study, the control group received its routine treatment; on the other hand, the intervention group received routine treatment and also the certified researcher, receiving the acupressure training, applied acupressure to the intervention group by using the points Li4, ST36 and SP6 3 times a week for a total of 4 weeks. The postacupressure fatigue mean score was 5.2 ± 0.7 in the intervention group and 5.9 ± 0.7 in the control group, and there was a significant difference in the control and intervention groups in terms of postacupressure fatigue mean scores (P < .05). According to these results of the study, it can be recommended to provide acupressure training to patients with multiple sclerosis in order to decrease the fatigue associated with multiple sclerosis.

The role of constitutional features of body structure in the occurrence and course of multiple sclerosis (literature review)

Annotation. The widespread prevalence of multiple sclerosis in different parts of the world among representatives of different races, nationalities, age groups, gender groups, chronic course of disease, the high cost of treatment and a significant percentage of disability of the working population makes this disease more relevant for scientific research than ever. One of the understudied aspects of domestic scientists is the anthropometric indicators іn group of patients suffering from multiple sclerosis. The aim of the study is to conduct a review a literary sources for the period 2012-2022, related to the topic of the human constitution and multiple sclerosis. A study of 29 sources that met the inclusion criteria was carried out. For the most part, the following anthropometric indicators were found in the publications, which had one or another reliable connection with the risk of occurrence or the course of multiple sclerosis: body mass index, ratio of muscles and fat in the body, waist circumference. Also important factors that were pay attention to account by the researchers and as a result in addition influenced the results of the research were: nationality, race, age and sex. According to the data of the analyzed studies, body mass index has the greatest contribution to the rate of disease progression between the studied groups with different course of multiple sclerosis, while sex had a greater influence on the occurrence of a certain specific type of course of multiple sclerosis. Accordingly to the analysis of literary sources revealed that there is a need to conduct an anthropometric study of Ukrainians suffering from multiple sclerosis in order to further form groups of key indicators that can be used to predict the risk of occurrence and course of this disease. This will become possible due to conducting a clinical and anthropological study that will be carried out in the future.

Relationship between circadian rhythm characteristics and chronotypes with multiple sclerosis: literature review

Circadian rhythm disorder is described as discrepancy between person’s sleep habits and usual, generally accepted sleep model during 24-hour period. Circadian rhythm disorders affect not only person’s working capacity during the day but also may reduce quality of life. The term chronotype refers to a specific circadian rhythm manifestation – person’s preference to sleep and to be awake at some point of 24-hour period. Both circadian rhythm disorders and increased serum levels of proinflammatory cytokines are considered as factors negatively affecting sleep homeostasis among patients with multiple sclerosis. It is important to recognize and manage circadian rhythm variations and associated sleep disorders among patients with multiple sclerosis in order to reduce fatigue, improve cognitive functions and mood, and general quality of life. In this review article, we describe mechanism of action of circadian rhythm, its imbalances, objective and subjective evaluation methods of circadian rhythm and chronotypes, as well as relationship between circadian rhythm characteristics, chronotypes, melatonin concentration, oxidative stress, and multiple sclerosis.

Living with multiple sclerosis in South Africa: how is multiple sclerosis experienced in the workplace?

Purpose The aim of this qualitative study was to explore how individuals living with multiple sclerosis experience their disorder in the South African working environment. In this paper we present the experiences of office-based workers living with multiple sclerosis, their challenges, and coping mechanisms. Material and methods We purposively recruited seven participants who have been diagnosed with multiple sclerosis in the last five years. Participants were interviewed telephonically. Interviews were guided by a semi-structured interview schedule which was supplemented with additional probes. Interviews were analysed thematically using a qualitative software programme. Results We identified two superordinate themes: bringing multiple sclerosis into the workplace and adapting to multiple sclerosis in the workplace. The findings demonstrated the diverse manner in which participants chose to disclose their multiple sclerosis and manage co-workers’ perceptions of multiple sclerosis. Participants employed practical strategies, such as making using of mobility aids, taking notes, conserving energy, and adapting responsibilities. Participants also negotiated accommodations, such as changing working hours, to overcome their unique challenges. Participants emphasised the importance of keeping a general positive attitude but showed reluctance to prepare for their future decline. Conclusion Our findings indicate that participants manage the disclosure of their diagnosis of multiple sclerosis in order to maintain a favourable relationship with the workplace. Further, despite various physical and psychological limitations, participants were mostly able to adapt to their work environment. Although further research is required, employers and clinicians should consider focusing on the current needs of individuals living with multiple sclerosis to mitigate work-related challenges, rather than planning for future decline. Implications for Rehabilitation For individuals living with multiple sclerosis and in employment in South Africa, disclosure, management of perceptions and providing accommodations are key aspects in the experience of multiple sclerosis in the workplace. Finding ways to help those in employment disclose their MS diagnosis to employers and co-workers, is an important avenue and next step for intervention research in this field. Early adjustment and adaptation to MS in the workplace is challenging and further negotiation with line-managers regarding accommodations is often required. Employers and clinicians should focus on accommodating the needs of those diagnosed with multiple sclerosis as they arise, rather than focusing solely on the accommodations needed in the future.

Evaluation of laboratory research data in patients with multiple sclerosis in the aspect of comboridity

The objective of the work – to study laboratory data in patients with multiple sclerosis in order to clarify the nature of the influence of comorbid pathology on the level of dysfunction of biochemical processes of the body. We examined 216 patients with multiple sclerosis with various forms of course. Patients of the general sample were divided into two groups: І (n = 109) – without concomitant diseases and ІІ (n = 107) – with the presence of concomitant diseases. The results of general clinical tests of blood and urine, a biochemical blood test, a study of cerebrospinal fluid, the immune status of the blood, and the level of autoantibodies to brain antigens were evaluated. General clinical blood and urine tests, a biochemical blood test were performed on all 216 patients with multiple sclerosis from the study group. The study of cerebrospinal fluid (macroscopic, microscopic, polymerase chain reaction) and immunological blood tests (study of indicators of cellular and humoral immunity, the level of autoantibodies to brain antigens) were performed in 42 patients with multiple sclerosis of both groups. As a result, it was found that significant differences between groups І and ІІ exist due to an increase in platelet counts in patients of group ІІ (P &lt; 0.05) and AsAT concentration (P &lt; 0.05), an increase in creatinine concentration (P &lt; 0.05), an increase in blood cholesterol (P &lt; 0.05). Such differences in the indicators of general clinical and biochemical blood tests are, in our opinion, due to the presence of cardiovascular and gastroenterological comorbidity in patients with multiple sclerosis and correlate with a decrease in their overall well-being. As a result of studying the general analysis of urine in 84.7 % of patients of the general sample, there were general inflammatory signs, which were more pronounced in several indicators in the ІІ group of patients, clinically correlated with the severity of pelvic disorders. Systemic and deeper changes in the level of NK cells, the main protein of myelin, the total human brain antigen, as well as the immunoregulatory cycle in patients with multiple sclerosis with comorbid pathology were also established.

Multiple Sclerosis: Promising New Treatment - A Clinical Review

Objective: In this update on multiple sclerosis, the main clinical aspects and the basic features of the diagnosis including the new McDonald criteria, symptoms, pathophysiology, therapy and multiple sclerosis status in Saudi Arabia is discussed. Method: reviewed available diagnosis methods and therapies. Conclusion: A new McDonald criterion is useful tool for the diagnosis of multiple sclerosis. An initial symptom of multiple sclerosis is weakness in one or more limbs (40%).demyelination is the main pathophysiological event. Disease-modifying treatment focuses on the long term management of the disease with the aim to reduce relapse rates, lessen severity, and to slow the progression of disability and cognitive decline. Multiple sclerosis is not common in Saudi Arabia, it may be fairly prevalent, under-diagnosed and in increasing. there is need to educate the common community mostly rural community by awareness, attitude and knowledge about multiple sclerosis in order to enhance patient’s adherence to treatment and his/her quality of life.

Depiction of dentatorubrothalamic tract fibers in patients with Parkinson's disease and multiple sclerosis in deep brain stimulation.

BackgroundWe wanted to depict fibers of the dentatorubrothalamic tract in patients with Parkinson’s disease and multiple sclerosis in order to use this knowledge for clinical routine and to show its relation to the corticospinal tract for deep brain stimulation. Fibers of these white matter tracts were depicted between February 2014 and February 2015 in nine patients of all ages. There were seven men and two women. The mean age was 60 years. We used a 3DT1 sequence for the navigation. Additional scanning time was less than 9 min. Both tracts were portrayed in all patients.ResultsWe were able to successfully portray these white matter tracts in all patients. We visualized the medial and lateral parts of the corticospinal tract by using a region of interest which covered the whole motor cortex. Furthermore we segmented the motor cortex. The fibers ran from this area of the brain through the internal capsule and they could be followed until their entry in the brainstem. The dentatorubrothalamic tract was smaller than the corticospinal tract. It was situated medio-posteriorly of the corticospinal tract. After decussation to the contralateral red nucleus it was localised next to the midline when it entered the motor cortex. From the thalamus on, it proceeds medially and posteriorly of the corticospinal tract further to the motor cortex. Depiction of the whole tract is essential for the differentiation of the dentatorubrothalamic tract with the corticospinal tract.ConclusionsThe depiction of the dentatorubrothalamic tract might be useful for neurosurgeons when deep brain stimulation is planned. Knowing its relation to other white matter tracts can help physicians like neurosurgeons or neurologists avoid side effects and deal with patients with DBS. The position of the electrode might be crucial for a satisfactory outcome.

Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: a randomized controlled trial

Objective: Evaluate the effects of a Pilates exercise programme on walking and balance in people with multiple sclerosis and compare this exercise approach to conventional physical therapy sessions. Design: Randomized controlled trial. Setting: Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. Subjects: Forty-five people with multiple sclerosis, 29 females, mean age (SD) was 43.2 (11.6) years; mean Expanded Disability Status Scale (S.D) was 4.3 (1.3). Interventions: Participants received 12 weekly training sessions of either Pilates (n=22) or standardized physical therapy (n=23) in an outpatient basis. Main measures: Spatio-temporal parameters of walking and posturography parameters during static stance. Functional tests included the Time Up and Go Test, 2 and 6-minute walk test, Functional Reach Test, Berg Balance Scale and the Four Square Step Test. In addition, the following self-report forms included the Multiple Sclerosis Walking Scale and Modified Fatigue Impact Scale. Results: At the termination, both groups had significantly increased their walking speed (P=0.021) and mean step length (P=0.023). According to the 2-minute and 6-minute walking tests, both groups at the end of the intervention program had increased their walking speed. Mean (SD) increase in the Pilates and physical therapy groups were 39.1 (78.3) and 25.3 (67.2) meters, respectively. There was no effect of group X time in all instrumented and clinical balance and gait measures. Conclusions: Pilates is a possible treatment option for people with multiple sclerosis in order to improve their walking and balance capabilities. However, this approach does not have any significant advantage over standardized physical therapy.

Practicing Patienthood Online: Social Media, Chronic Illness, and Lay Expertise

The use of digital technologies and social media by people with serious illness to find, share, and create health information is much celebrated but rarely critiqued. Proponents laud “Health 2.0” as transforming health care practice and empowering patients. Critics, however, argue that a discourse of developing lay expertise online masks the disciplinary practices of the neoliberal state’s emphasis on individual responsibility. Notably, the perspectives of people who are engaging with social media related to their health and illness are under-represented in this debate. This research examines the experiences and perspectives of women who blog about their lives with Multiple Sclerosis in order to situate them in the context of these conflicting ideologies. Methods consisted of an ethnographic content analysis (N = 40), an online survey (n = 20), and an online discussion forum (n = 9). Findings revealed that blogging is neither inherently empowering nor inevitably disciplinary. Rather, it simultaneously offers opportunities for patients to gain medical knowledge and resist medical patriarchy, as well as compounds expectations placed upon patients to assume greater responsibility for managing their care.

Results of the implementation of a pharmaceutical care programme for patients with multiple sclerosis

ObjectivesThe aim of the present work was to establish a specialised pharmaceutical care programme for patients with multiple sclerosis in order to analyse its effects on patient satisfaction, the detection...

Meningeal inflammation plays a role in the pathology of primary progressive multiple sclerosis

The primary progressive form of multiple sclerosis is characterized by accrual of neurological dysfunction from disease onset without remission and it is still a matter of debate whether this disease course results from different pathogenetic mechanisms compared with secondary progressive multiple sclerosis. Inflammation in the leptomeninges has been identified as a key feature of secondary progressive multiple sclerosis and may contribute to the extensive cortical pathology that accompanies progressive disease. Our aim was to investigate the extent of perivascular and meningeal inflammation in primary progressive multiple sclerosis in order to understand their contribution to the pathogenetic mechanisms associated with cortical pathology. A comprehensive immunohistochemical analysis was performed on post-mortem brain tissue from 26 cases with primary progressive multiple sclerosis. A variable extent of meningeal immune cell infiltration was detected and more extensive demyelination and neurite loss in the cortical grey matter was found in cases exhibiting an increased level of meningeal inflammation. However, no tertiary lymphoid-like structures were found. Profound microglial activation and reduction in neuronal density was observed in both the lesions and normal appearing grey matter compared with control cortex. Furthermore, cases with primary progressive multiple sclerosis with extensive meningeal immune cell infiltration exhibited a more severe clinical course, including a shorter disease duration and younger age at death. Our data suggest that generalized diffuse meningeal inflammation and the associated inflammatory milieu in the subarachnoid compartment plays a role in the pathogenesis of cortical grey matter lesions and an increased rate of clinical progression in primary progressive multiple sclerosis.

Documento de consenso de la Sociedad Española de Neurología sobre el uso de medicamentos en esclerosis múltiple: escalado terapéutico

Introduction Treatment of multiple sclerosis has advanced considerably in the last few years, at the same time as its complexity has increased. The purpose of this consensus document is to provide specific recommendations and rules on the strategy to follow in the treatment of multiple sclerosis in order to modify its course. Material and methods Experts on the treatment and clinical research on multiple sclerosis proposed by the Demyelinating Diseases Group of the Spanish Neurology Society (SEN) prepared an initial document with recommendations for the treatment of this disease. The final version of this document was submitted to members of the Demyelinating Diseases Group of the SEN, who were able to make modifications and suggest changes to the final manuscript. Results and conclusions A review has been made of the evidence levels and indications for the treatment of the different clinical forms of multiple sclerosis, and recommendations made for the use of drugs. As well as authorised drugs, a review has also been made of other occasionally used products, as well as combined therapy, therapeutic response criteria, levels of treatment changes, and finally a proposal is made on therapeutic escalation.

Spanish Neurology Society consensus document on the use of drugs in multiple sclerosis: Escalating therapy

Introduction Treatment of multiple sclerosis has advanced considerably in the last few years, at the same time as its complexity has increased. The purpose of this consensus document is to provide specific recommendations and rules on the strategy to follow in the treatment of multiple sclerosis in order to modify its course. Material and methods Experts on the treatment and clinical research on multiple sclerosis proposed by the Demyelinating Diseases Group of the Spanish Neurology Society (SEN) prepared an initial document with recommendations for the treatment of this disease. The final version of this document was submitted to members of the Demyelinating Diseases Group of the SEN, who were able to make modifications and suggest changes to the final manuscript. Results and conclusions A review has been made of the evidence levels and indications for the treatment of the different clinical forms of multiple sclerosis, and recommendations made for the use of drugs. As well as authorised drugs, a review has also been made of other occasionally used products, as well as combined therapy, therapeutic response criteria, levels of treatment changes, and finally a proposal is made on therapeutic escalation.

Living and Dying with Dignity: Reflections on Lived Experience

Considerations of human dignity figure prominently in discussions of health care, and are central in the debate with regard to end-of-life care and the issue of physician-assisted suicide. In this paper I reflect on my experience as a person living with multiple sclerosis in order to explore ways in which prevailing cultural values contribute to the loss of dignity that accompanies incurable illness and disability. I suggest that authentic Christian community may offer an alternative culture with a radically different value system, one that enhances human dignity.

Caring as worrying: the experience of spousal carers.

With the emerging focus on home-based care, there is an increasing demand on spouses to look after their chronically ill partners at home. The theoretical aspects of caring have been much discussed in the literature, but the pragmatic aspects have received less attention. Carer stress has been explored, but little has been written about the meaning of caring to informal carers. The aim of this paper is to report one of the major themes that emerged from a study conducted between 1998 and 1999 to explicate the meaning of caring from the perspective of spousal carers for people with multiple sclerosis in order to shed light on and understand the challenges and demands these carers encountered. An interpretive phenomenological approach was used to describe spousal carers' experiences of caring for their partner. Ten spousal carers of people with multiple sclerosis participated. Data were collected through unstructured in-depth interviews and analysed by the method of hermeneutic analysis. This paper presents one of the major themes identified: 'caring as worrying'. While the meaning of caring that emerged from this theme supports many of the philosophical understandings of caring as discussed in the literature, worrying as a care responsibility provides a further insight. Caring as worrying describes caring as a complex emotional relationship of responsibility in these participants. They worried about their partners, their relationships with their partners and their future. They also worried about their own health, institutional care, and lack of government support. Spousal carers' worries have significant implications for health care professionals. The findings provide insight into the concerns and worries the carers of people with multiple sclerosis face when caring for their chronically ill partners at home.

The lived experience of disability

In this paper I reflect upon my personal experience of chronic progressive multiple sclerosis in order to provide a phenomenological account of the human experience of disability. In particular, I argue that the phenomenological notion of lived body provides important insights into the profound disruptions of space and time that are an integral element of changed physical capacities such as loss of mobility. In addition, phenomenology discloses the emotional dimension of physical disorder. The lived body disruption engendered by loss of mobility includes a change in the character of surrounding space, an alteration in one's taken-for-granted awareness of (and interaction with) objects, the disruption of corporeal identity, a disturbance in one's relations with others, and a change in the character of temporal experience. The loss of upright posture is of particular significance since it not only concretely diminishes autonomy but affects the way one is treated by others. Such a change in posture is, therefore, particularly disruptive in the social world of everyday life. An understanding of the lived body disruption engendered by disability has important applications for the clinical context in devising effective therapies, as well as for the social arena in determining how best to resolve the various challenges posed by chronic disabling disorders.