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dc.contributor.authorFeinstein, A
dc.contributor.authorFreeman, J
dc.contributor.authorLo, AC
dc.date.accessioned2018-02-19T13:23:34Z
dc.date.available2018-02-19T13:23:34Z
dc.date.issued2015-02
dc.identifier.issn1474-4422
dc.identifier.issn1474-4465
dc.identifier.urihttp://hdl.handle.net/10026.1/10817
dc.description.abstract

Disease-modifying drugs have mostly failed as treatments for progressive multiple sclerosis. Management of the disease therefore solely aims to minimise symptoms and, if possible, improve function. The degree to which this approach is based on empirical data derived from studies of progressive disease or whether treatment decisions are based on what is known about relapsing-remitting disease remains unclear. Symptoms rated as important by patients with multiple sclerosis include balance and mobility impairments, weakness, reduced cardiovascular fitness, ataxia, fatigue, bladder dysfunction, spasticity, pain, cognitive deficits, depression, and pseudobulbar affect; a comprehensive literature search shows a notable paucity of studies devoted solely to these symptoms in progressive multiple sclerosis, which translates to few proven therapeutic options in the clinic. A new strategy that can be used in future rehabilitation trials is therefore needed, with the adoption of approaches that look beyond single interventions to concurrent, potentially synergistic, treatments that maximise what remains of neural plasticity in patients with progressive multiple sclerosis.

dc.format.extent194-207
dc.format.mediumPrint
dc.languageen
dc.language.isoeng
dc.publisherElsevier BV
dc.subjectAnimals
dc.subjectDepression
dc.subjectExercise Therapy
dc.subjectHealth Services Needs and Demand
dc.subjectHumans
dc.subjectImmunologic Factors
dc.subjectMultiple Sclerosis
dc.subjectMuscle Fatigue
dc.subjectPhysical Therapy Modalities
dc.subjectTreatment Outcome
dc.titleTreatment of progressive multiple sclerosis: what works, what does not, and what is needed
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/25772898
plymouth.issue2
plymouth.volume14
plymouth.publisher-urlhttp://dx.doi.org/10.1016/s1474-4422(14)70231-5
plymouth.publication-statusPublished
plymouth.journalThe Lancet Neurology
dc.identifier.doi10.1016/s1474-4422(14)70231-5
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/School of Health Professions
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
plymouth.organisational-group/Plymouth/Users by role/Researchers in ResearchFish submission
dc.publisher.placeEngland
dc.identifier.eissn1474-4465
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1016/s1474-4422(14)70231-5
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review


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