Non-motor symptoms in Multiple Sclerosis

Multiple sclerosis (MS) is the most common disease of the brain and spinal cord in young people. European doctors started talking about a new epidemic: multiple sclerosis came out on top among the diseases leading to disability of young people. In the course of the disease, an autoimmune inflammation occurs, which causes damage to the myelin layer surrounding the nerve cells. Damage occurs in numerous foci of the brain and spinal cord. Currently, there are more than 2 million patients with MS in the world [1]. Multiple Sclerosis (MS) is an autoimmune disease that leads to a demyelination process. The clinical picture of the disease is complex, and an important part of it are the non-motor symptoms, such as: dysphagia, sleep disorders, fatigue and pain, and the bladder function disorders. Some questionnaires were used to assess some of the dysfunctions listed above. The treatment of non-motor symptoms in patients with multiple sclerosis is based on the use of a various forms of therapy: pharmacotherapy, physiotherapy and surgical treatment. The aim of these is to improve the quality of life of the patient. The aim of this work is to present non-inguinal disorders occurring in patients with MS. The bibliographic databases were searched: PubMed, MedLine, Polish Medical and others. Bibliography. Articles in Polish and English were used

Physiotherapy in myasthenia gravis

Myasthenia gravis (MG) is a rare neuromuscular disease with an autoimmune background. It is characterized by the presence of antibodies directed against the acetylcholine receptor. Diagnosing MG poses a lot of difficulties because it is characterized by high variability of symptoms. The most important symptoms of this disease are weakness and excessive muscular fatigue. Diagnosis of the MG requires carrying out a diagnostic tests with a broad spectrum. One of the elements of the comprehensive treatment of patients with MG is the implementation of appropriate physiotherapeutic procedures. Together with other forms of therapy, it alleviates the symptoms of the disease and improves the quality of life of people with myasthenia. The aim of this work is to present diagnostic methods and physiotherapeutic possibilities in one of the neuromuscular diseases - myasthenia gravis. The bibliographic databases were searched: PubMed, Polish Medical Bibliography and Medline. Articles in Polish and English were used

Methods for assessing selected disorders of the autonomic nervous system in neurodegenerative diseases

Neurodegenerative diseases belong to the group of progressive disease entities leading to pathological changes in nerve cells. Loss of nerve cells causes numerous motor and non-motor disorders, which include autonomic nervous system (AUN) disorders. The aim of the study is to review the available literature on the most frequently occurring disorders of the autonomic nervous system occurring in neurodegenerative diseases and methods of their diagnosis. For this purpose, databases such as MedLine, PubMed, Cochrane Library and Polish Medical Bibliography were searched. Articles in Polish and English were selected. The paper presents the methods most commonly used to assess the autonomic nervous system, cardiovascular disorders. Accounted for methods that, thanks to their ease of implementation, have found wide clinical application. Non-invasive methods include, among others: analysis of heart rate variability, 24-hour blood pressure monitoring, tilt test and deep slow breathing test. In addition to the above-mentioned studies and tests, the literature also includes questionnaires for assessing dysautonomy. The most commonly used is the Lowa Autonomous Symptom Questionnaire. Studies published so far confirm the need to use AUN assessment in neurodegenerative diseases. Diagnosis and treatment of nervous system dysautonomics is important from the point of view of a holistic therapeutic approach

Assessment of autonomic nervous system function in a patient suffering from multiple sclerosis - a case study

Background: Multiple sclerosis (MS) is a chronic demyelinating disease of the nervous system. In its course, there are many motor and non-motor disorders, including the autonomic system disorders. They are characterized by an increase or decrease in the activity of the autonomic nervous system. The course of the disease is most often multi-phase, there are periods of remission and exacerbation. The aim of the study is to assess cardiovascular parameters and heart rate variability in response to orthostatic stimuli in a patient with multiple sclerosis. Material and Method: A 48-year-old woman suffering from multiple sclerosis for 10 years (a form of secondary progressive disease) participated in the study. A study was carried out for cardiovascular response and heart rate variability in response to orthostatic stimuli. For this purpose, the Task Force Monitor system was used, which is a non-invasive method that allows the assessment of hemodynamic parameters such as heart rate, systolic blood pressure, diastolic blood pressure, and peripheral vascular resistance. Spectral heart rate variability (HRV) analysis was also used to assess the function of the autonomic nervous system. The evaluated parameters were: low-frequency component (LF), high-frequency (HF) and sympathetic-parasympathetic balance factor (LF / HF). Results: In the rest position, an autonomic balance shift was observed towards sympathetic domination. After performing the tilt test, the patient had an after pionization drop in blood pressure (orthostatic hypotension) as well as vascular resistance. Conclusions: The analysis of the case study shows that in multiple sclerosis there may be disorders of the autonomic nervous system manifested by abnormal regulation of arterial pressure in a vertical position

Assessment of fatigue and autonomic dysfunction in myasthenia gravis – case report

Introduction: Myasthenia gravis (MG) is an autoimmune disease in which neuromuscular conduction disorders occur. The reason is the loss of acetylcholine receptors and the presence of antibodies directed against these receptors. The most characteristic symptoms of myasthenia gravis are: tenderness and weakness of striated muscles, which intensify particularly during exercise and in the evening. Non-motor symptoms such as: fatigue, disorders of the autonomic nervous system can be asymptomatic, and in a significant proportion of cases significantly affect the quality of life. A full understanding of non-motors symptoms is needed to treat patients with MG. The aim of the study was to present the characteristics of non-motor symptoms on the example of a patient with myasthenia gravis. Material and methods: A 50-year-old woman who had been suffering from myasthenia gravis for 23 years was examined. Chalder Fatigue Scale, Epworth Sleepiness Scale, Orthostatic Grading Scale were used to evaluate non-motor symptoms. The orthostatic reaction was tested using the tilt test. Results: The most frequently reported non-motors symptoms in the patient were: chronic fatigue, sleep disturbances and cardiovascular symptoms (orthostatic intolerance, weakness). Conclusions: Myasthenia gravis is characterized by a large variability of symptoms. An important part of the clinical picture are non-motor symptoms that can affect the functioning of patients in everyday life

Dementia as a disease of old age

Background: The increase in chances of dementia with age translates into huge numbers of patients. Her diagnosis is often difficult to indicate and treatment is still about fighting the symptoms and not the disease itself. Material and methods: A review of the literature and WHO research was carried out indicating the greater progression of the disease in old age and the stages of the course of the disease. Results and conclusions:The disease progresses gradually and it is very difficult to make a correct diagnosis in the early stadium. There are various ways to diagnose dementia, but doctors still have a major role to do in close contact with the patient. Rapid diagnosis can significantly slow down the disease, but it cannot be cured completely

Multiple sclerosis and dizziness in the elderly

Background:The essence of sclerosis disseminated, characteristics of the symptoms of this disease and familiarization with the main difficulties that sick people face. Material and methods:The methods used to treat balance disorders and dizziness are pharmacotherapy, vestibular rehabilitation, lifestyle changes and surgical treatment. Results: The results are not very optimistic, treatment is not too easy symptoms are manifested in motor dysfunction leading to even disability Conclusions:Multiple sclerosis is a disease affecting the nerve center of unknown etiology which makes treating difficult. The onset of the disease is often dizziness or headache

A rehabilitation approach to the falls of geriatric patients

Abstract: Background: Falls of the elderly are not only in themselves one of the most common problems of geriatric patients, but also the cause of many complications that affect permanently or for a shorter period of time affect the quality of life of people over 65 years of age. These changes affect not only the efficiency and motility of the elderly but also may reduce self-esteem, limit social life or cause loss of self-confidence. Material and methods: Analysis of available literature, articles in the Google Scholar database and PubMed using keywords: falls, geriatrics, aging process, problem Results: In clinical practice, many tests and scales are used to prevent the fall of older people and related complications. These include: Timed Up & Go (TUG), Tinetti scale, Dynamic Gait Index (DGI), One Leg Standing (OLS), Four Square Step Test (FSST), Berg test or Functional Reach (FR). Preventing falls can primarily be achieved by the use of appropriate rehabilitation methods, which include, among others, kinesitherapy and properly selected orthopedic equipment. The aim of individually selected kinesitherapy is to restore or maintain the patient's full fitness through the use of physical exercises to improve the balance, increasing mobility and efficiency. In the case of orthopedic supplies, the most common are baby walkers (without wheels, walker with wheels, using a triangular and quadrangular base) and orthopedic balls. Conclusions: Prophylaxis to prevent destructive effects of falls of geriatric patients should be carried out in a comprehensive manner and cover a wide range of activities. There is a further need for research and discussion on the effectiveness of forms of rehabilitation to prevent the falls of older peopl

Knee arthroplasty in the elderly

Background: One of the many problems related to geriatric patients are degenerative changes in joints. In this article authors discuss about the knee joint endoprosthesis. During preparations of this publishment special attention was paid to the following aspects: role and the meaning of preventing actions, explanation the clue and main goal of the surgery intervention, and it’s simplified course. Subsequently there are short description of the knee joint with its most relevant to the fallowing subject structures. Furthermore the quantity of respective surgical procedure was given to approximate the scale of subject. Next paragraphs explaining why endoprothesis is the best way for dealing with this kind of problems, and the significance of the physiotherapist in whole process both before, and after surgery. Materials and methods: Analysis of available literature and articles in PubMed, ResearchGate and other scientific platforms related to discussed subject, using words: geriatrics, endoprothesis, knee arthroplasty, knee joint. Results: Gonarthrosis is a significant social problem. Endoprosthesis plastic surgery is performed on those patients who struggle badly in activities of daily living because of advanced articulations disorders. The main diagnoses underlying the primary knee replacement were primary bilateral gonarthrosis and other primary gonarthrosis accounted. The analysis of sources devoted to these issues includes people after 65 years old (mostly women) which occurs a low level of physical activity, the burden of metabolic disease such as diabetes (type 2). Authors demonstrated a correlation between excessive body weight, and insufficient production of synovial fluid, it’s damage and in the final phase lost which is a direct reason for pain. The following thesis was proven based on the source material: thanks to arthroplasty the patients quality of life as improved by around 90 percent. When the physiotherapist is involved in the whole process, both in the pre- and post-surgery phase it is possible to obtain much better therapeutic effects. Conclusions: Knee arthroplasty can help restore independence to patients in their daily activities. The introduction of artificial foreign bodies into the pond to replace the damaged leads to an improvement in the quality of life of sick patients. The introduction of intensive rehabilitation, patient education and pharmacological treatment after arthroplasty allows for reduction of pain and faster recovery. There are many types of rehabilitation after knee replacement surgery, so the therapy plan has to be adapted to the individual patient

Sarcopenia as a problem of old age - a form of rehabilitation

Background: Sarkopenia as a disease has relatively recently become the object of research and the work of the academic community. Despite this, sarcopenia is an increasingly serious social problem, it can be seen in a large number of statistics and epidemiological studies. Among geriatric patients, along with their multiformity and the associated use of a large amount of medicines, it causes many negative effects related to the functioning of the whole organism as well as the quality of life of the patient himself. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: sarcopenia, geriatrics, rehabilitation, loss of muscle mass. Results: Among the studies and recommendations concerning sarcopenia, a continuous lack of clear, transparent and confirmed diagnostic criteria can be stated. At the diagnosis of this disease, an X-ray or a bioelectrical impedance analysis is used. Other methods used are functional tests, including a six-minute walk test or "Timed-Up and Go" test (TUG). In the case of rehabilitation of people with sarcopenia, the most effective form of kinesitherapy is individually selected resistive training, which has a positive effect not only on muscle mass growth, but also the body's protein metabolism and the improvement of the endocrine system. Physiotherapy is the most commonly used method of physical therapy, among other methods of rehabilitation there are also therapeutic massage, aqua aerobics, vibratory training, and Nordic Walking and diet supplementation. Conclusions: Sarcopenia in geriatric patients, especially with ineffective treatment and rehabilitation, has a destructive impact on both the physical and mental sphere of the patient. There is a great need for more extensive research, both on the whole disease process and the effectiveness of forms of assistance to patients