Interventions for Multiple Sclerosis

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Age Cohort: 60+ years

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Creation of awareness among the communities,Families on multiple sclerosis including prevention measures Provision of IEC materials on multiple sclerosis Community health workers training on multiple sclerosis	Smoking cessation Healthy balance diet Exercises Use of Vitamin D.and low exposure to sunlight is associated with reduced risk of MS.	Recognition of symptoms that are indicative of multiple sclerosis including; Numbness or weakness in one or more limbs, Electric-shock like sensations that occur with certain neck movements, especially bending the neck forward, lack of coordination or unsteady gait loss of vision Plenty of rest including getting enough sleep for the elderly with multiple sclerosis Healthy balanced diet Vitamin D supplements with potential benefit of relieving stress Regular Exercises to improve the muscle strength, muscle tone, balance and coordination. Referral to a health facility	Community based/home based rehabilitation for elderly persons with multiple sclerosis Encourage Regular Physical Exercise programs for elderly persons with multiple sclerosis E to improve the muscle strength, muscle tone, balance and coordination Generalized relaxation techniques such as gentle rocking to improve flexibility
Primary Care
Creation of awareness among the communities. Families on multiple sclerosis including prevention measures Provision of IEC materials on multiple sclerosis Community health workers training on multiple sclerosis	Smoking cessation Healthy balance diet Exercises Use of Vitamin D.and low exposure to sunlight is associated with reduced risk of MS. Early diagnosis and management of pre-disposing conditions such as pernicious anemia, psoriasis, type 1 diabetes or inflammatory bowel disease	Physical and clinical examination Recognition of symptoms that are indicative of multiple sclerosis including Numbness or weakness in one or more limbs, Electric-shock like sensations that occur with certain neck movements, especially bending the neck forward, lack of coordination or unsteady gait loss of vision Plenty of rest including getting enough sleep for the elderly with multiple sclerosis Regular Exercises to improve the muscle strength, muscle tone, balance and coordination. Healthy balanced diet Vitamin D supplements with potential benefit of relieving stress Referral to a hospital	Encourage Regular Exercises to improve the muscle strength, muscle tone, balance and coordination.	Community based social support systems and counselling support for elderly persons with multiple sclerosis and their families to be able to cope with the disease and its possible complications Stress management
Referral Facility: General
Creation of awareness among the communities/Families on multiple sclerosis including prevention measures Provision of IEC materials on multiple sclerosis Community health workers training on multiple sclerosis	Smoking cessation Healthy balance diet Exercises Use of Vitamin D. and low exposure to sunlight is associated with reduced risk of MS. Early diagnosis and management of pre-disposing conditions such as pernicious anemia, psoriasis, diabetes or inflammatory bowel disease.	Physical and clinical examination Therapy focused on returning function after an attack, preventing new attacks and preventing disability Management of acute attack with high doses of intravenous corticosteroids e.g. oral prednisone and intravenous methylprednisolone Diagnostic test Paralysis, Depression, Epilepsy Blood tests Spinal tap (lumbar puncture) MRI. Plasma exchange (plasmapheresis). Follow up and management of complications Including Muscle stiffness or spasms; Paralysis, Depression, Epilepsy	Occupational therapy on how to perform daily tasks. Physical therapy physical for muscle strengthening exercises Physical therapy to manage leg weakness and other gait problems often associated with MS.	Community based/home based rehabilitation for elderly persons with multiple sclerosis Encourage Regular Physical Exercise programs for elderly persons with multiple sclerosis E to improve the muscle strength, muscle tone, balance and coordination Generalized relaxation techniques such as gentle rocking to improve flexibility
Referral Facility: Specialist
Creation of awareness among the communities/Families on multiple sclerosis including prevention measures Provision of IEC materials on multiple sclerosis Community health workers training on multiple sclerosis	Early diagnosis and management of pre-disposing conditions such as pernicious anemia, psoriasis, diabetes or inflammatory bowel disease. Smoking cessation Healthy balance diet Exercises Use of Vitamin D. and low exposure to sunlight is associated with reduced risk of MS.	Physical and clinical examination Therapy focused on returning function after an attack, preventing new attacks and preventing disability Management of acute attack with high doses of intravenous corticosteroids e.g. oral prednisone and intravenous methylprednisolone Diagnostic test:- Blood tests Spinal tap (lumbar puncture) MRI. Plasma exchange (plasmapheresis). Follow up and management of complications Including Muscle stiffness or spasms; Paralysis, Depression, Epilepsy	Occupational therapy on how to perform daily tasks. Physical therapy physical for muscle strengthening exercises Physical therapy to manage leg weakness and other gait problems often associated with MS.	Community based/home based rehabilitation for elderly persons with multiple sclerosis Encourage Regular Physical Exercise programs for elderly persons with multiple sclerosis E to improve the muscle strength, muscle tone, balance and coordination Generalized relaxation techniques such as gentle rocking to improve flexibility