An Introduction to NINDS Multiple Sclerosis

Multiple sclerosis is an ite4ong chronic disease diagnosed primarily in young adults. (NINDS Multiple Sclerosis Information Page 2000 p.1) Multiple Sclerosis (MS) is a disease of unknown cause that affects the nervous system. it may cause problems with vision, strength, coordination, speech, bladder control, sensation, or other faculties governed by the eyes, brain, or spinal cord. Both men and women are affected. These types of problems are caused by this disease and the severity of those problems vary greatly from person to person.

In any affected individual, the type and severity of problems associated with the disease are also likely o vary from year to year. How the disease will start, what course it will flow, and what chronic problems the affected person will acquire are unpredictable(Lechtenberg, 1995 p1). Multiple means more than one and sclerosis refers to areas of scarred tissue. Multiple Sclerosis is also the most common demyelinating disease of the central nervous system.

During an MS attack, inflammation occurs in areas of the white matter of the central nervous system nerve fibers that are the site of MS lesions) in random patches called plaques, This process is followed by the destruction of myelin, which insulates nerve cells in the brain and spinal cord.

Myelin facilitates the smooth, high-speed transmissions of electrochemical messages between the brain, the spinal cord, and the rest of the body(NINDS 2000 pi).

MS varies considerably from one person to another. It can cause different symptoms which affect various parts of the body. Many people only experience a few of these symptoms and no one has all of them(MS Society 2000 1).

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Symptoms may include tingling, pins, and needles. numbness, double 0 blurred vision, clumsiness of fine movements or walking, frequency and urgency of urination, muscle weakness and spasms, pain or paralysis, incoordination, and mood or thought disturbances. Motor symptoms include weakness, spasticity, ataxia (loss of balance), and speech disorders.

Sensory symptoms include pins and needles, tingling, feelings of tightness or solidity, and sometimes, sharp pains. Visual symptoms include blurred or double vision, involuntary eye movements, and on occasion blindness, which is almost always temporary. Energy problems include lack of energy, easy fatigability, and lack of endurance, particularly in the presence of heat and humidity. Symptoms may appear very rapid, within minutes or days, or very slowly, for ora period of weeks. They may be very transient and come and go rapidly. New symptoms or worsening of old symptoms may reappear and intensify. My aunt is struggling with MS and her doctor has taught her to look for persistence
and duration in symptoms, and she tries to be reasonably nonchalant about those that are fleeting in appearance. Symptoms vary because the location and extent of each attack vary. There is usually a stepwise progression of the disorder, with episodes that last days, weeks, or months altering with times of reduced or no symptoms (remission).

Research into the underlying causes and processes of multiple sclerosis is ongoing, and in recent years, advances in immunology have rapidly increased knowledge and understanding of the disease. Multiple Sclerosis is not a genetically transmitted disease. Multiple Sclerosis may also be or involve detection of some kind in the body’s autoimmune system, some part of the body may, in effect attack set.

There are four main types of MS and a lot of differences within them. The four different types of multiple sclerosis are benign, relapsing/remitting, secondary progressive, and primary progressive MS. People with benign MS stars with a small number of mid attacks followed by complete recovery. it does not worsen over time and there is no permanent disability. The first symptoms are usually sensory, Relapsing/remitting MS means that the person has attacks following remissions. During remission, they have fewer oF and no symptoms (remissions are periods of recovery).

Secondary Progressive MS starts the same way as relapsing-remitting MS but after repeated attacks, the remission stop and the MS moves into what is known as the progressive phase. The last type of MS is primary progressive MS. Some people with MS never have distinct relapses and remissions. From the start, they experience steadily worsening symptoms and progressive disability. This may level off at any time, or may continually get worse.

There is no cure for multiple sclerosis. Many promising modes of treatment are being developed. posted but most remain experimental. The commonly available treatments are essentially palliative. One drug which has been shown to shorten the duration and intensity of acute exacerbations(an acute appearance of new symptoms or worsening of old symptoms which last at least 24 hours) is. adrenocorticotropic hormone (ACTH). a pituitary gland substance that stimulates the adrenal glands to produce additional cortisone, which acts to reduce the inflammation in the brain or spinal cord. ATHC does not affect the underlying disease processes but may diminish the frequency and severity of exacerbations and even slow the progression of the disease. Steroids were the principal medications for MS. While steroids can not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients(NINDS MS information home page 2000 pi).

The degree to which students with disabilities have their physical education needs to be addressed in a public school setting is an ongoing concern. it has been stated that most students with mid disabilities can cope with the routine of regular physical education classes (Broadhead, 1965). There are many ways to adapt different activities to a physical education class so that a student with multiple Sclerosis or any other disability can participate just like the other students without feeling left out.

If a person with MS were to participate in physical activity education it would be important. Before a physical education teacher takes on the responsibility of working with a student or students with multiple sclerosis they should know some specific precautions for a program of general exercise.

Fatigue and overheating can sometimes worsen the symptoms of MS, so you must pay attention to the signals of the student. Since many people with MS often experience difficulty with balance, you need to be cautious during any exercise requiring this skill (Simmons 1986 p.275) Simmons also says that in addition to fatigue and overheating, you should be aware of any increase in spasticity or remorse, pain, any dizziness or loss of balance, or any generalized feelings of stress or anxiety (1986). Teachers should be aware of the students’ physical ability and limits before they have them participate in physical education classes.

Adapted physical education is an individualized program of physical and motor fitness; fundamental motor skills and patterns; and skills in aquatics, dance, and individual and group games and sports designed to meet the unique needs of individuals (Winnick 2000 p). Adapting isto modifying objectives and activities to meet the needs of special students so that they can participate with the whole class. Timing of the activity I important to avoid fatigue or the Hotter times of the day. With Some guidelines, a good activity can help to develop the maximum potential of muscle, bone, and respiration thereby avoiding secondary complications (Multiple Sclerosis 2000 p2). A few different sports that can be adapted to meet the needs of all students in the class are soccer, football, tumbling, bowling, volleyball, and swimming.

Soccer can be easily adapted to the class by making three different games going at the same time. One game can be a regular game of soccer with a regular soccer ball, the other field can be a kickball a little bigger than the soccer ball(ts softer), and in the third game the students can use a beach ball bigger than the kickball and the goal size can be widened. When giving out positions to the students try Not to make the student with the disability the goalie. It puts a lot of pressure on them and can give them a feeling of failure when they are scored on.

For football, the class can be separated into two groups. One of the games can have a regular football (playing touch or flag football of course). On the next field, the students can use a bigger  football that is softer like anerf balll and make the field smaller This way the student can participate in a.game that they are more comfortable with

Another activity that a teacher can adapt in their class is tumbling. This would be the best activity to adapt to because there is a broad range of activities that they can all participate in. You can have the students do tumbling activities on mats that would be laid out and they could also use the balance beam (low to the floor. This would be a good activity for the student with MS to have fun with the line that is far away oF the closest line to the pins. if they start close and they are doing better then they can move back when they feel more comfortable.

Volleyball can be adapted also to meet special students’ needs that can also be fun for everyone. The teacher may want 10 to use a big beach ball and allow multiple touches on the volley. The team can score points by getting the other team to let the ball hit the floor.

Swimming would be the best activity for a student with multiple sclerosis in a physical education class. Swimming and water aerobics are very popular for students with MS, probably because they allow students who are weak to be able to use the buoyancy of water to perform some activities they have trouble doing otherwise (Kraft, Catanzaro 1996 p49). The students can use kickboards and just use their legs to get around. The teacher can lead the class in aqua aerobics. This is also a great activity because it keeps the student’s temperature down while they are
exercising.