Secondary Progressive Multiple Sclerosis (MS)

Secondary Progressive Multiple Sclerosis (MS) создатель Diamond Collins

1. Vital Signs

2. Cranial nerves

3. Balance

4. BP: 124/76

5. Pulse: 64 bpm

6. Respiratory rate: 18 breaths/min

7. progressive weakness, balance problems, spasticity, sensory disturbances, cognitive impairments

8. affects sensory, motor, and autonomic pathways

9. Pathophysiology

10. Cognition

11. Sensation

12. Perception

13. chronic, inflammatory demyelinating disease of the CNS

14. mild impairments with processing speed. memory. cognitive challenges

15. Motor

15.1. Tone

15.2. Control

15.3. Strength

16. spasticity; lower extermities

17. impaired coordination: dysdiadochokinesia

18. Weakness; both UEs and LEs

19. compensation weakness; decreased hip/knee flexion during swing, decreased dorsiflexion

20. Gait: ataxia, scissoring

21. normal sitting

22. loss of balance

23. Sensory loss

24. impaired light touch and proprioception in L lower extermity; balance/coordination difficulties

25. cognitive challenges: affect functional performance

26. Cardiovascular/endurance

27. Functional Skills

27.1. Functional transfer

27.2. Ambulation

28. Vestibular Examination

29. VOR cancellation: normal

30. 6 Minute walk test: 1,111 ft with B walking poles; reduced cv endurance/possible fatigue

31. TUG: 19s; functional mobility limitations

32. floor to stand - independent w/ support when fatigued

33. sit to stand - independent but with decreased stability, wgt shift to R LE, bilateral knee valgus collapse.

34. MSIS-29: 55% physical, 37.8% psychological; significant impact on both physical and emotional health

35. Outcome measures

36. Modified fatigue impact scale: 51/84; mod fatigue

37. Stairs: difficult ascending stairs when fatigues --> weakness and coordination impairments

38. FGA: 11/30; high risk for falls

39. unsteady surfaces: need contact guard assist w/ B walking poles, min assist w/o AD

40. 5X sit to stand test: 27.04s; severed difficulty w/ postural transitions, support motor control/strength deficits

41. Community distance: mod independent with B walking poles

42. secondary progressive MS: worsening w/o acute pathways

43. 10-meter walk test: 1.03 m/s (self-selected), 1.26 m/s (fast); slow walking speeds, weakness, possible fatigue

44. Short distance: independent

45. Gaze stability: negative

46. mCTSIB: 2s; instability with eyes closed/foam surface.

47. examination: normal

48. Berg balance: 41/56; moderate balance impairment

49. sinlge limb stance: 3s L, 6s R; imbalance/weakness L LE

50. standing: tandem stance 5.9s L, 11.3s R; significant asymmetry

51. Cardiovascular: no abnormalities