OT 537 Session 8A Take-Away

     In this class session, we learned about multiple sclerosis and muscular dystrophy. Multiple sclerosis (MS) is a demyelinating disease that is unpredictable and disables the central nervous system. MS is considered an autoimmune disease because the body's own defenses attack the protective myelin covering the CNS. MS is the most common neurological disease in young adults. Symptoms of MS include weakness, intention tremor, nystagmus, Babinski sign, dysphagia, dysmetria, and many more. The focus of OT intervention for clients who have MS would be removing and reducing barriers in order to promote/enable the client to participate in meaningful occupations. OT would also focus on the maintenance of current functional abilities.
     Muscular dystrophy (MD) is caused by muscle being poorly nourished because of degeneration. MD is a result of a change in the muscle itself, and not in the nerve or neuromuscular junction; this distinguished MD from other diseases that cause muscle weakness as a result of nerve damage. The mother carries the gene for MD and passes it along to her child. MD is more common in males because they only have one copy of the dystrophin gene, and if that copy is defective then their muscles are affected. MD is a group of disorders caused by genetic mutations, usually in the dystrophin gene. Dystrophinopathies are the most common, such as Duchenne muscular dystrophy and Becker muscular dystrophy. Duchenne MD is caused by a lack of dystrophin, is very severe, and symptoms usually occur by age 5. Becker MD is caused by a misshapen dystrophin gene, has mild symptoms, and appears between the ages of 10-20. Children with Duchenne MD tend to walk later in life, have a waddling gait, and develop enlarged calves from buildup of fat and fibrotic tissue in their muscles. Gower's sign is a hallmark of Duchenne MD, and it happens when the child is laying on their stomach and they use their arms to help them stand up because of weakened hip and upper leg muscles. Later symptoms of MD include confinement to a wheelchair, respiratory failure, scoliosis, and arrhythmias; this leads to a shorter lifespan. The role of OT for clients with MD is improving breathing, preventing contractures, addressing strength and endurance, mobility, and bathroom modifications so clients can perform meaningful occupations.