Orthotic Management of Multiple sclerosis

Definition
It is an autoimmune condition in which the immune system attacks the central nervous system, leading to demyelination

Causes
Unknown, but likely occurs as a result of some combination of both environmental and genetic factors.

Signs & Symptoms
• Visual Symptoms: Blurred vision, eye pain, loss of colour vision, blindness, etc
• Motor Symptoms: Spasticity, Muscle weakness, wasting of muscles, Footdrop, etc
• Sensory Symptoms: Paraesthesia, Anaesthesia, etc
• Coordination and Balance Symptoms: Ataxia, Intention tremor, etc

Complications
• Contractures: knee flexion contractures, elbow flexion contractures, etc
• Deformity: equinus, etc

Orthotic Treatment
It depends in the location and severity of conditions. If Upper limb effected, Upper Limb Orthoses can be prescribed, for example when the wrist extensor weakness is present, Cock up splint can be used. If Lower limb effected, Lower Limb Orthosis can be prescribed. for example, dorsi flexion assist AFO (Leaf Spring AFO) can be prescribe when patient having Foot drop. But when it becomes equinus, Rigid AFO can be prescribed. So many orthoses can be prescribed according to the severity of condition, but main objectives of orthotic treatment should be followed.

Objective Orthotic Intervention
a. To provide stability for the limb
b. To providing safety and stability & comfort
c. To prevent or Reduces contractures
d. To prevent or correct deformity
e. Control of undesirable motions while permitting motion which occurs normally.

f. Protection of weak muscle.
g. Control of deviations associated with tonus abnormality.
h. Enhancement of experience for those patients who can experience upright posture with the support of biomechanical support devices.

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