NeuroRehabilitation - Volume 3, issue 4

Article Type: Other

DOI: 10.3233/NRE-1993-3401

Citation: NeuroRehabilitation, vol. 3, no. 4, pp. iv-iv, 1993

Authors: DeLuca, John

Article Type: Introduction

DOI: 10.3233/NRE-1993-3402

Citation: NeuroRehabilitation, vol. 3, no. 4, pp. vi-vi, 1993

Authors: Bansil, Shalini | Troiano, Raymond | Dowling, Peter C. | Rohowsky-Kochan, Christine | Cook, Stuart D. | Barbieri-Berger, Susan

Article Type: Research Article

Abstract: Multiple sclerosis (MS) is an acquired inflammatory demyelinating disease of the central nervous system (CNS) believed to be of autoimmune pathogenesis. Progressive MS is a common cause of disability in young adults in the United States. Although several immunomodulating therapies have been tested in clinical and animal studies, there is no known treatment that prevents further progression and disability. Current research efforts are being focused on the development of novel, safe immunospecific treatments. Until such therapies become available, a major component of patient management should be to relieve symptoms, prevent complications, and maximize function in activities of daily living. A …team approach involving health care professionals of various specialties is ideal for the management of patients with progressive MS. Show more

DOI: 10.3233/NRE-1993-3403

Citation: NeuroRehabilitation, vol. 3, no. 4, pp. 1-8, 1993

Authors: DeLuca, John | Johnson, Susan K.

Article Type: Research Article

Abstract: Neuropsychological functioning in multiple sclerosis (MS) has recently become an area of increased interest to health care professionals. This article reviews how various cognitive domains are affected by MS. Studies have shown impairments in individuals with MS in the areas of memory, information processing, complex attention, visuospatial functions, and executive functioning while ability is generally preserved in the intellectual and language domains. The implications of these findings for cognitive rehabilitation in MS is discussed.

DOI: 10.3233/NRE-1993-3404

Citation: NeuroRehabilitation, vol. 3, no. 4, pp. 9-16, 1993

Authors: Ponichtera-Mulcare, Janet A. | Glaser, Roger M.

Article Type: Research Article

Abstract: Multiple sclerosis (MS) is a neurological disease characterized by a variety of potentially debilitating symptoms. The manner in which the disease affects each individual is unique. Many individuals with MS have minimal neuromuscular impairment and remain ambulatory throughout their lives, whereas others experience more rapid disease progression and loss of functional independence. Although appropriate exercise testing and training could potentially improve clinical treatment and rehabilitation outcome, very little research has focused on understanding how MS affects basic physiologic responses during exercise. Objective measurements of muscle function and cardiopulmonary (aerobic) fitness have indicated variable results depending upon the disease severity. Patient-specific …information is important for establishing realistic guidelines for therapeutic exercise programs. It appears that appropriate training can improve both skeletal muscle function and cardiopulmonary fitness. However, current clinical indices of neurologic function do not consider physical capability as part of the criteria. Thus, it seems desirable to supplement these criteria with objective tests of exercise performance. Special precautions and considerations for exercise testing of individuals with MS need to be incorporated to ensure safety and accurate interpretation of data. Show more

DOI: 10.3233/NRE-1993-3405

Citation: NeuroRehabilitation, vol. 3, no. 4, pp. 17-29, 1993

Authors: LaRocca, Nicholas G. | Kalb, Rosalind C. | Foley, Frederick W. | McGann, Carol M.

Article Type: Research Article

Abstract: Multiple sclerosis (MS) challenges the individual, the family, and society because (1) it can produce wide-ranging functional losses; (2) it is generally progressive with functional losses increasing over time; and (3) its course is unpredictable. Persons affected by MS respond by (1) experiencing changes in their perception of themselves and their world; (2) altering their social roles; and (3) undergoing a variety of emotional responses, especially depression and grief over the losses caused by the illness. Psychosocial interventions that address MS challenges include (1) educational interventions such as lectures, workshops, and books; (2) supportive interventions such as counseling and support …groups; (3) psychoeducational interventions such as communication skills training; and (4) somatic therapies such as antidepressants. The unpredictable and progressive course of MS means that affected individuals face a lifetime of periodic challenge. Comprehensive care in MS must address the psychosocial challenges of the illness on a long-term basis. In this way MS care can address the whole patient. Show more

DOI: 10.3233/NRE-1993-3406

Citation: NeuroRehabilitation, vol. 3, no. 4, pp. 30-38, 1993

Authors: Britell, Catherine W. | Cooper, Laura D. | Law, Nancy

Article Type: Research Article

Abstract: A majority of individuals with multiple sclerosis (MS) are not employed, even though most are at an age of prime employability and have been successfully employed in the past. Factors that have been shown to decrease employment in these individuals include mobility impairment, bladder and bowel dysfunction, impairment in activities of daily living, cognitive dysfunction, social and family issues, lack of physical and functional access to the workplace, and attitudes of the patient, family, and employer about chronicity and disability in MS. This paper reviews the functional, psychosocial, and legal barriers to employment in these individuals and discusses effective interventions …to maintain or regain successful employment in this population. Show more

DOI: 10.3233/NRE-1993-3407

Citation: NeuroRehabilitation, vol. 3, no. 4, pp. 39-47, 1993

Authors: Holland, Nancy J. | Cavallo, Pamela F.

Article Type: Research Article

Abstract: This article addresses sexuality within the context of living with multiple sclerosis (MS). A discussion of MS-related dysfunction is followed by assessment tips and a range of interventions. Psychosocial and societal issues are reviewed as well as practice implications for health professionals.

DOI: 10.3233/NRE-1993-3408

Citation: NeuroRehabilitation, vol. 3, no. 4, pp. 48-56, 1993

Authors: Foley, Frederick W. | LaRocca, Nicholas G. | Kalb, Rosalind C. | Caruso, Lauren S. | Shnek, Zachary

Article Type: Research Article

Abstract: Numerous studies have described an association between stress and the onset or exacerbation of multiple sclerosis (MS). Most of the studies that have been conducted to date, however, have had methodological flaws including: (1) retrospective designs, (2) inadequate or absent control groups, (3) small sample sizes, (4) clinical measures that are insensitive to underlying disease activity, and (5) wide variation in the measurement of stress. Animal models of MS have enabled researchers to examine the effects of stress directly in the central nervous system. Stress affects three biological systems that may be dysregulated in MS: the neuroendocrine system, the sympathetic …nervous system, and the serotonergic neurotransmitter system. Future stress-MS research should evaluate the relationship between stress and these systems. Show more

DOI: 10.3233/NRE-1993-3409

Citation: NeuroRehabilitation, vol. 3, no. 4, pp. 57-66, 1993