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Symptom Management in Multiple Sclerosis

Demos Vermande, 386 Park Avenue South, Suite 201, New York NY 10016, USA 1998. 3 rd edn (ISBN 1 888799 22 6) lllus 204 oaaes

by Randall T Schapiro MD $25 + $4 postage This respected author in the field of multiple sclerosis (MS) has enhanced his previous publication with new information, in light of recent research advances in disease management and drug management for specific symptoms of MS. The author’s stated goal ofthis edition is ‘to enhance the lives of people with multiple sclerosis’. It is aimed at people with MS and their carers and friends, and is a reference for health care professionals involved in the management of MS.

The book is easy to read with good layout and use of tables, charts and diagrams. It is divided into three sections.

Section 1 discusses anatomy of the nervous system, the mechanism of MS, symptoms of MS and possible causes. It goes on to discuss medical care but as it is American, a lot of this section is not relevant in the UK. Finally it provides an update on new drugs available to affect the disease process.

The second section is very well written, with background research evident, although no actual references are given. It has many chapters, each covering a specific symptom and its drug and rehabilitation management. Where appropriate an explanation of normal mechanism and how it is altered in MS is provided. This is useful for professionals as a review, and for patients as an explanation of symptom causes. Symptoms covered include fatigue, spasticity, tremor, dizziness and numbness. Some chapters are more relevant than others. A multidisciplinary team approach is encouraged , a n d understanding of the concept of exercise for maintenance is evident throughout the book.

The final section encompasses maintenance rehabilitation, exercise and diet in more detail, and adapting to life with MS. Appendices show exercises in diagrammatic form and transfer techniques with text and diagrams. Most of these are pertinent and are clear, but one or two look dubious.

The main drawback throughout is the American terminology, which may cause difficulties for people. The language and style are simple and clear. Patients should find it easy to understand although professionals may find some of the suggested strategies tedious.

For physiotherapists and students, it provides an insight into the complexity of MS management. The diagrams may be useful. It provides a balanced text to encourage patients to read, promoting self-management.

This is a worthy reference for physiotherapy and occupational therapy departments to own. It is recommended for any person interested in or coming into contact with people with MS, whether as a professional or a friend/carer, who wants to know the current strategies in MS care.

Jenny Craig MCSP

1. Near a piece of furniture, get on to your hands and knees

2. Facing the furniture, push up on to your knees

3, Assist with to bring your leg UP

4. Place your on the floor

one hand strongest

foot flat

5. Lean forward and using your arms and legs push up to half- stand

6. Turn and sit on the furniture

I Steps to getting up from rhe floor in ‘Symptom Management in Multiple Sclerosis‘

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Physiotherapy June 1999/vol85/no 6