| 1. |
- Alonso-Magdalena, Lucía, et al.
(författare)
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Incidence and prevalence of multiple sclerosis in Malmö, southern Sweden
- 2022
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Ingår i: Multiple Sclerosis International. - : Hindawi Publishing Corporation. - 2090-2654 .- 2090-2662.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To estimate the incidence and prevalence of multiple sclerosis (MS) in Malmö municipality in southwestern Sweden.MATERIALS AND METHODS: Multiple sources were used in the case identification process. Case ascertainment was assessed by medical chart review including examinations such as magnetic resonance imaging, cerebrospinal fluid analyses, and relevant laboratory tests. Cases were classified according to the 2010 McDonald's diagnostic criteria. Onset-adjusted prevalence and a definition of onset symptoms were applied.RESULTS: The crude incidence of MS in 2001-2010 in Malmö municipality was 5.3/100,000 (95% confidence interval (CI): 4.5 to 6.2). There was a relapsing onset in 90.5% of cases. The female to male ratio was 1.8. The onset-adjusted prevalence for Dec 2010 was 133/100,000 (95% CI, 120 to 146) with a female to male ratio of 2.1.CONCLUSIONS: This is the first population-based epidemiological study in Skåne, the most southwestern part of Sweden showing a high incidence and prevalence. We found a lower incidence than expected according to previous nationwide figures, probably due to methodological differences between the studies. Our findings support the presence of a north-south gradient of MS prevalence in Sweden.
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| 2. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Effects on Balance and Walking with the CoDuSe Balance Exercise Program in People with Multiple Sclerosis : A Multicenter Randomized Controlled Trial
- 2016
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Ingår i: Multiple Sclerosis International. - New York, USA : Hindawi Publishing Corporation. - 2090-2654 .- 2090-2662.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Balance and walking impairments are frequent in people with multiple sclerosis (MS).Objective: The aim was to investigate the effects of a group-based balance exercise program targeting core stability, dual tasking, and sensory strategies (CoDuSe) on balance, postural sway, walking, perceived walking limitations, and balance confidence.Design: A single-blinded randomized multicenter trial. No intervention was given to controls. Participants. People with MS able to walk 100 meters but unable to maintain tandem stance >= 30 seconds. Eighty-seven participants were randomized to intervention or control.Intervention: The 60-minute CoDuSe group program, twice weekly for seven weeks, supervised by physical therapists.Measurements: Primary outcome was dynamic balance (Berg Balance Scale (BBS)). Secondary outcomes were postural sway, walking (Timed-Up and Go test; Functional Gait Assessment (FGA)), MS Walking Scale, and Activities-specific Balance Confidence (ABC) Scale. Assessments were performed before and after (week 8) the intervention.Results: 73 participants fulfilled the study. There were significant differences between the intervention and the control groups in change in the BBS and in the secondary measures: postural sway with eyes open, FGA, MS Walking Scale, and ABC scale in favor of the intervention.Conclusions: The seven-week CoDuSe program improved dynamic balance more than no intervention.
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| 3. |
- Gamage, SMK, et al.
(författare)
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Multiple Sclerosis Patients with Markedly Low Intrathecal Antibody Response in Sri Lanka
- 2018
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Ingår i: Multiple sclerosis international. - : Hindawi Limited. - 2090-2654 .- 2090-2662. ; 2018, s. 5342936-
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Tidskriftsartikel (refereegranskat)abstract
- Multiple sclerosis (MS) is a heterogeneous disease which is poorly studied in Asia, where the disease is known to be rare with significant differences in clinical and radiological presentations and intrathecal antibody response. Therefore the objective of this study was to determine clinical presentation, radiological and neurophysiological characteristics, and oligoclonal band status in Sri Lankan MS patients, following careful exclusion of patients with neuromyelitis optica spectrum disorders and other conditions mimicking multiple sclerosis. Sixty-nine MS patients were recruited to the study adhering to McDonald 2010 criteria. Their clinical presentation, characteristics of central nervous system lesions in magnetic resonance imaging, visual evoked potential (VEP) results, oligoclonal bands (OCB), and AQP4 antibody status were studied. Of 69 MS patients, 54%, 6%, and 1% were relapsing remitting, secondary progressive, and primary progressive, respectively, and 39% were patients with clinically isolated syndrome. The commonest clinical presentations were cerebral motor followed by cerebral sensory and optic neuritis. Majority had typical periventricular and infratentorial lesions in MRI. Though not clinically apparent, bilateral delay of P100 wave latency was present in 52%. OCB positivity was 42% and AQP4 antibody was positive in only one patient. In conclusion, this group of Sri Lankan MS patients shares most of the clinical and radiological features of Caucasian MS patients. However, the OCB positivity is lower in this group, when compared to the Caucasian MS populations.
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| 4. |
- Kobelt, G, et al.
(författare)
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Real-Life Outcome in Multiple Sclerosis in the Czech Republic
- 2019
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Ingår i: Multiple sclerosis international. - : Hindawi Limited. - 2090-2654 .- 2090-2662. ; 2019, s. 7290285-
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Tidskriftsartikel (refereegranskat)abstract
- Background. Cohort studies and registries provide opportunities to estimate long-term outcome in multiple sclerosis. Objectives. To describe changes in disability (EDSS), relapse activity, and health care consumption over the period 2008-2015 by combining two Czech cost-of-illness studies with disease data from the MS Center in Prague. Methods. The combined dataset included 426 patients with a mean observation time of 8.3 years. A Cox proportional hazards model with time-varying covariates for treatment, disease course, and EDSS was applied to estimate the effect of treatment on the risk of progression to EDSS 4 and the risk of relapses. The use of health care resources (hospitalization, consultation, and tests) was compared between the two cross-sectional studies. Results. Total health care costs appeared stable between 2008 and 2015, despite more intense use of disease-modifying treatments in 2015 (52% of patients versus 31% in 2008). 39% of patients starting treatment at EDSS 0-3 in 2008 progressed to EDSS 4 or higher by 2015, while 65% of patients starting at EDSS 0-2 remained stable. The number of relapses was associated with a higher risk of progression. In a marginal structural Cox model of the relapse risk, treatment with natalizumab or fingolimod was associated with a lower risk of relapse (hazard ratio 0.68, p<0.01). Treatment with natalizumab or fingolimod was associated with a lower risk of progression to EDSS 4. Conclusion. Our results link relapses to progression and indicate that the newer treatments have a better effectiveness, despite difficulties caused by small a sample size, administrative rules guiding treatment, and absence of a random comparator group.
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| 5. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Activities-specific balance confidence in people with multiple sclerosis
- 2012
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Ingår i: Multiple Sclerosis International. - New York, USA : Hindawi Publishing Corporation. - 2090-2654 .- 2090-2662. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the validity of the Activities-specific Balance Confidence scale (ABC) in people with multiple sclerosis (PwMS). Design. A multicentre, crosssectional study. Setting. Six rural and urban Swedish sites, including specialized units at hospitals and primary care centers.Participants: A sample of 84 PwMS with subjective gait and balance impairment but still able to walk 100 m (comparable with EDSS 1–6).Outcome Measures: Timed Up and Go, Timed Up and Gocog, 25-foot Timed Walk Test, Four Square Step Test, Dynamic Gait Index, Chair Stand Test, 12-item MS Walking Scale, selfreported falls, and use of assistive walking device were used for validation. Results. The concurrent convergent validity was moderate to good (0.50 to −0.75) with the highest correlation found for the 12-item MS Walking Scale. The ABC discriminated between multiple fallers and nonfallers but not between men and women. Ecological validity is suggested since ABC discriminated between users of assistive walking device and nonusers. The internal consistency was high at ? = 0 . 9 5 , and interitem correlations were between 0.30 and 0.83.Conclusion: This study supports the validity of the ABC for persons with mild-to-moderate MS. The participants lacked balance confidence in many everyday activities, likely restricting their participation in society.
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| 6. |
- Westerdahl, Elisabeth, 1964-, et al.
(författare)
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Pulmonary Function and Respiratory Muscle Strength in Patients with Multiple Sclerosis
- 2021
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Ingår i: Multiple Sclerosis International. - : Hindawi Limited. - 2090-2654 .- 2090-2662. ; 2021
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Tidskriftsartikel (refereegranskat)abstract
- Background: In patients with multiple sclerosis (MS), there is a decline in muscle strength and physical capacity due to demyelination and axonal loss in the central nervous system. In patients with advanced MS or in a later stage of the disease, also respiratory impairment may occur. The degree of pulmonary dysfunction in the earlier stages of MS has not been thoroughly described. Therefore, the primary aims of this study are to describe pulmonary function and respiratory muscle strength in patients with a moderate disease course and to identify associations between respiratory muscle strength and functional capacity.Methods: A sample of 48 patients with a diagnosis of MS and mean age 56 +/- 11 years was studied using a descriptive cross-sectional design. The patients had a disease duration of 24 +/- 11 years and a median Expanded Disability Status Scale (EDSS) score of 4.5 (interquartile range 4.0-6.5). Pulmonary function assessed by spirometry, respiratory muscle strength, peak cough flow and peripheral oxygen saturation, subjective breathing and coughing ability, and physical capacity measured using the 6MWT were evaluated.Results: The patients had normal pulmonary function with no significant abnormalities in dynamic spirometry (vital capacity 103 +/- 16% predicted, forced expiratory volume in 1 second 95 +/- 15% predicted). Peak expiratory flow rate 89 +/- 17% predicted was in the lower limit of normal. Respiratory muscle strength, determined by maximal inspiratory (MIP) and expiratory (MEP) static pressures, was normal but with large differences between individuals. MIP ranged from 26 to 143 cmH(2)O (98 +/- 31% predicted); the MEP values ranged from 43 to 166 cmH(2)O (104 +/- 29% predicted), with two patients having values below the lower limit of normal. Significant positive associations between MIP as well as MEP were found in several pulmonary function variables. A significant negative association was found between EDSS score and MEP (r=-0.312, p=0.031). Mean peak cough flow was 389 +/- 70 L/min, which is comparable with the values reported for healthy adults. The patients did not experience a severely decreased ability to take deep breaths or cough. There was a moderate correlation between MEP and physical capacity, as assessed by the 6MWT (r=0.399, p=0.010) and between peak expiratory flow (PEF) and the 6MWT (r=0.311, p=0.048).Conclusion: Respiratory muscle strength, pulmonary function assessed by spirometry, and peak cough flow were normal in patients with mild to moderate MS; however, there were large individual differences demonstrating low respiratory muscle strength in some patients. Significant associations between MEP and functional capacity and between MEP and disease severity were found, indicating that patients with impaired respiratory muscle strength have lower functional capacity and more severe disease.
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