ABSTRACT
Muscle strength, tone, and coordination are among the main determinants of a person’s ability to perform voluntary movements, and to function in the environment. Those living with multiple sclerosis (MS) and their caregivers know how impairments of these bodily functions often coexist and can therefore be dif„cult to address. Fortunately, interventions and treatments are available to remediate, albeit partially, some of these impairments. Thus, it is essential to assess each impairment separately and to integrate impairmentspeci„c interventions into individualized treatment and rehabilitation planning. After reading this chapter, you will be able to:
1. De„ne and describe changes in strength, tone, and coordination in relation to MS, 2. Explain how these impairments and their consequences can be assessed clinically,
and
CONTENTS
7.1 Muscle Tone ........................................................................................................................ 136 7.1.1 Prevalence and Impact .......................................................................................... 137 7.1.2 Identifying and Measuring Spasticity ................................................................ 137 7.1.3 Improving Spasticity ............................................................................................. 139 7.1.4 Key Points about Spasticity .................................................................................. 141
7.2 Muscle Strength ................................................................................................................. 142 7.2.1 Prevalence and Impact .......................................................................................... 142 7.2.2 Measuring Muscle Strength ................................................................................. 142 7.2.3 Improving Muscle Strength ................................................................................. 144
7.2.3.1 Medications .............................................................................................. 145 7.2.3.2 Strength Training .................................................................................... 145 7.2.3.3 Assistive Technology .............................................................................. 147
7.3 Coordination ....................................................................................................................... 150 7.3.1 Prevalence and Impact .......................................................................................... 151 7.3.2 Identifying and Measuring Incoordination ....................................................... 151 7.3.3 Improving Abnormal Coordination ................................................................... 152
7.3.3.1 Medications .............................................................................................. 152 7.3.3.2 Thalamic Surgery .................................................................................... 152 7.3.3.3 Rehabilitation ........................................................................................... 153
7.3.4 Key Points about Coordination and Tremor ...................................................... 154 7.4 Impact of Rehabilitation Setting ...................................................................................... 154 7.5 Conclusion and Directions for Future Research ........................................................... 154 References ..................................................................................................................................... 157
3. Give an overview of rehabilitation and treatment strategies, and illustrate with case studies.
