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Multiple sclerosis (MS) is a chronic autoimmune inflammatory demyelinating disease of the central nervous system with an unknown aetiology, which is the most common cause of neurological disability in young adults. The disease course is unpredictable and has an influence on all aspects of life. Due to the variability of clinical signs and symptoms in multiple sclerosis a full and accurate assessment is essential to determine the primary problems resulting from the disease pathology. The main clinical manifestations of the disease are reduced mobility, paresis, spasticity, pain, fatigue, ataxia, bladder, bowel and sexual dysfunction, dysfunction of speech, communication, swallowing and cognitive impairment. Comprehensive rehabilitation interventions reduce sequels and symptoms of disease and improve personal activities, social participation and quality of life. Physiotherapists plays an important role in management and treatment of reduced mobility in patients with MS. The assessment instruments for patients with multiple sclerosis are numerous. They can be used for assessing sequels of the disease, ability to move, functional ability of the patient, and for physiotherapy intervention planning. The International Classification of Functioning, Disability and Health (ICF) is designed to aid systematic assessment and objective planning of rehabilitation and to guide rehabilitation outcome measurement. Goal setting is now widely accepted as a basic principle of rehabilitation practice. It is essential that goal setting involves both the individual with MS and the rehabilitation team. Multidisciplinary rehabilitation is aimed at improving functional ability of patients with MS and contributing to integration of patients with MS into their work environment and the society. Multipla skleroza je kronična avtoimuna demielinizacijska bolezen osrednjega živčevja neznane etiologije, za katero najpogosteje zbolijo mladi ljudje. Potek bolezni je nepredvidljiv in vpliva na vse ravni življenja. Zaradi raznolike klinične slike pri multipli sklerozi (MS) je pomembno pravilno vrednotenje ugotovljenih simptomov in znakov. Najpogostejši simptomi so motena občutljivost, motnje hoje, vida, pareze udov, povišan mišični tonus, bolečine, utrudljivost, motnje ravnotežja, ataksija, motnje mokrenja, odvajanje blata in spolnih funkcij, motnje sporazumevanja, požiranja in kognitivne motnje. Celostna rehabilitacija zmanjša posledice in simptome bolezni ter izboljša bolnikove zmožnosti, sodelovanje in kakovost življenja. Fizioterapevt ima pomembno vlogo pri vodenju in obravnavi motenj gibanja pri bolnikih z MS. Številni merilni instrumenti se uporabljajo za ocenjevanje posledic multiple skleroze, zmožnosti gibanja, funkcijskih zmožnosti bolnika z MS in za načrtovanje fizioterapevtske obravnave. Mednarodna klasifikacija funkcioniranja, zmanjšane zmožnosti in zdravja (MKF) (angl. International classification of functioning, disability and health) je lahko osnova za sistematično ocenjevanje in načrtovanje rehabilitacije posameznika na vseh ravneh njegovega delovanja, za ocenjevanje poteka rehabilitacije in njenih izidov. Danes je splošno sprejet princip rehabilitacijske prakse, da rehabilitacijski tim skupaj z bolnikom določi cilje obravnave. Z multidisciplinarno obravnavo želimo izboljšati funkcijsko zmožnost bolnika z multiplo sklerozo, sodelovanje in kakovost življenja kljub napredovanju bolezni. |
