Cuprins

Ipoteza temei...............................................................................................................................1
Motivaia realizrii temei............................................................................................................1
Scopul i sarcinile cercetrii.......................................................................................................1
Metode de cercetare utilizate......................................................................................................2
Istoric al cercetrii epidemiologice n scleroz multipl3
Actualiti n epidemiologia sclerozei multiple..3
Factori demografici ...................................................................................................................3

Factorul genetic.................................................................................................................3

Factorul sex.......................................................................................................................4

Incidena.......................................................................................................................4

Scleroza multipl i sarcina..........................................................................................4

Vrsta de debut a bolii.......................................................................................................5

Factorul ras......................................................................................................................5

Frecvena...........................................................................................................................5

Obiectivele generale ale lucrrii.................................................................................................6

Capitolul I
Generaliti, clasificri i subdiviziuni ale sistemului nervos central.........................................6

Definiia, trsturile i particularitile scleozei multiple...........................................................9

Modul de debut.........................................................................................................................12

Manifestri clinice n scleroza multipl....................................................................................12

Neuropatia optic retrobulbar........................................................................................12

Manifestri motorii..........................................................................................................13

Manifestari senzitive.......................................................................................................14

Sindromul cerebelos........................................................................................................15

Tulburri legate de nervii cranieni..................................................................................15

Crizele paroxistice...........................................................................................................15
 Tulburri genito-sfincteriene...........................................................................................16

Durerea n scleroza multipl...........................................................................................16

Examinarea afeciunii...............................................................................................................17

Bilanul articular..............................................................................................................18

Bilanul muscular............................................................................................................18

Scala FID.........................................................................................................................20

ADL (activities of daily living).......................................................................................20

Scala Ashworth a spasticitii.........................................................................................21

Depistarea cazurilor de scleroz multipl i recomandri pentru persoanele n cauz............ 21

Tipuri de tratament...................................................................................................................22

Obiectivele programului de recuperare....................................................................................25

Inducerea activitii motorii voluntare............................................................................25

Ameliorarea feed-back-ului senzorial.............................................................................26

Inhibarea schemelor motorii nedorite.............................................................................26

Ameliorarea coordonrii.................................................................................................26

Prevenirea i tratarea redorii articulare i retracturilor musculare..................................26

Ameliorarea tulburrilor cerebeloase (ataxiei)................................................................26

Reducerea spasticitcii....................................................................................................27

Prevenirea i diminuarea limitrilor amplitudinilor de micare......................................27

Adaptarea psihologic la boal........................................................................................28

Terapii asociate tratamentului kinetic.......................................................................................28

Masajul............................................................................................................................28

Reflexoterapia.................................................................................................................28

Apiterapia........................................................................................................................29

Fizioterapia......................................................................................................................29

Crioterapia.......................................................................................................................30
Capitolul II

Materiale i metode folosite......................................................................................................31

Obiectivele programului de recuperare....................................................................................31

Programul kinetic......................................................................................................................32

Posturi pentru reducerea spasticitii...............................................................................33

Mobilizri pasive i exerciii de stratching.....................................................................33

Exerciii active.................................................................................................................39

Exerciii de echilibru i coordonare................................................................................42

Exerciii pentru reeducarea mersului...............................................................................43

Evaluarea pacientului cu scleroz multipl..............................................................................46

Evaluarea iniial......................................................................................................................50

Evaluarea final........................................................................................................................53

Capitolul III

Interpretri, discuii, concluzii..................................................................................................56