Il ruolo del tecnico della riabilitazione psichiatrica nella valutazione multifunzionale della persona affetta da sclerosi multipla

ABSTRACT Background: Multiple Sclerosis (MS) is a chronic degenerative disease of the central nervous system (CNS), it is characterized by destruction of the myelin sheath (demyelination) . SM was described first by A. Carswell and Cruveilhier and after by Jean- Martin Charcot . Despite the progress of scientific research the causes of Multiple Sclerosis are not yet known. Several studies show that the basis of Multiple Sclerosis is an autoimmune mechanism in which the immune system attacks the body's own tissues as it perceives them as ¿foreign¿, the etiology is still unknown. The main symptoms are both physical and mental and frequently , over time , these develop into disability. Currently there are no definitive therapies which eliminate completely the disease, however, there are numerous treatments that reduce the incidence and severity of attacks in most cases of this illness. Objective: This dissertation emphasizes the importance, in health care, of secondary prevention. In diseases such as Multiple Sclerosis, secondary prevention is essential, because are chronic degenerative diseases that affect the lives of patients. In order to give these patients a good quality of life you must analyze, monitor and act on the various consequences and manifestations of the disease. This dissertation aims to highlight the ability to perform effectives screening exams without high resources. The aspects on which I have focused attention in this dissertation are cognitive and tonic - postural diseases because numerous studies have shown that these elements affect the quality of life. 5 Method: in the research were recruited 80 patients with Multiple Sclerosis, aged between 18 and 50 years, belonging to the Regional Reference Center Multiple Sclerosis (CReSM) at the San Luigi Gonzaga Hospital in Orbassano. In order to compare the data obtained, from the patients, were also taken into consideration healthy subjects with the same age. In both groups, was then identified a representative sample, 20 patients and 20 healthy subjects homogeneous for age. The two groups were subjected to both psychometric (Symbol Digit Modalities Test) and tonic - postural assessment (Limits of Stability and modified Clinical Test of Sensory Interaction on Balance) at the CReSM. Results: in the execution of the Symbol Digit Modalities Test the patients had lower scores than healthy people and there has been a correlation between score and education in subjects aged between 25 and 34 years. Performing the tonic ¿ postural tests the scores obtained by patients are slightly lower in some performances but without indicating severe motor deficits because the disease, in these patiens, has recently been diagnosed. Conclusions: through the analysis of data obtained in the psychometric exam it's possible states the importance to keep the mind in training whatever the medical condition. Examining data of tonic - postural tests I have noticed that whatever types and intensity of alteration is important to make accurate assessments periodically in order to monitor the situation and intervene in order to optimize the residual motor abilities of the person. Keyword: Multiple Sclerosis, cognitive disfunction, tonic ¿ postural disfunction, Symbol Digit Modalities Test, Limits of Stability, modified Clinical Test of Sensory Interaction on Balance