Research on lower extremity health in patients with multiple sclerosis: a systematic scoping review
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(2020) 13:54
REVIEW
Open Access
Research on lower extremity health in patients with multiple sclerosis: a systematic scoping review Minna Stolt1* , Anne-Marie Laitinen1,2, Juhani Ruutiainen3,4 and Helena Leino-Kilpi1,2
Abstract Background: Multiple sclerosis (MS) often affects ambulation and the function of the lower limbs. However, little is known about how much research has been conducted on lower extremity health in patients with MS. Objective: To analyse empirical studies and their evidence on lower extremity health in patients with MS, in order to identify the need for future studies in key areas. Methods: A systematic scoping review was conducted. A literature search of Medline (PubMed), CINAHL (EBSCO) and the Cochrane Library databases was performed. The search covered the period up to 15 January 2020 from the earliest records available. This led to the inclusion of 42 empirical articles. The data were analysed using content analysis and quantification techniques. Results: The research on lower extremity health focused primarily on two main areas: gait and lower extremity muscle strength. Lower extremity health was assessed using a variety of methods, most of which consisted of objective physical tests and gait analysis. Patients with MS had many problems with the health of their lower extremities, which manifested in walking difficulties, balance problems, muscle weaknesses and spasticity. In the feet, pes cavus, claw toes, oedema and altered foot sensation were common. Conclusions: MS affects lower limb and foot health, and these problems can affect patients’ daily lives. However, the extent of these problems is poorly understood, partly due to the dearth of research on lower limb and foot health. Therefore, further research is warranted in order to better understand the impact of MS on foot and lower limb health in everyday life. Keywords: Multiple sclerosis, Lower extremity, Research, Review
Introduction Multiple sclerosis (MS) is an immune-mediated disease with a wide variation in its clinical course. Most patients with MS are initially diagnosed with a relapsingremitting form of the illness, and the progression usually begins at around 40 years of age [1]. It is estimated that in 2016, there were more than 2.2 million prevalent cases of MS worldwide [2]. The highest estimates on * Correspondence: [email protected] 1 Department of Nursing Science, University of Turku, 20014 Turku, Finland Full list of author information is available at the end of the article
prevalence per 100,000 people were for North America (167) and Western Europe (127) [2]. In a recent Finnish registry study, the mean age of patients with a new diagnosis of MS was 37.0 years (range: 15–69) and the female/male ratio was 2.6 [3]. Spasticity and weakness in the lower extremities are among the most common signs and symptoms of MS. As such, the validated Expanded Disability Status Scale (EDSS), [4] the most commonly used rating scale for disability in MS, is heavily based on the motor function of the lower limbs. Ambulatory impai
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