الفهرس 
Multiple sclerosisOnly 14 pages are availabe for public view
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Abstract
Upper limb intentional tremor is commonly found multiple sclerosis patients. Tremors were closely associated with damage to the cerebellum or its connections. Tremors also associated with hypotonia, which further limits functional performance. Upper-limb intention tremor is strongly correlated with disability in MS patients and affect the activities of eating, drinking, picking up the phone, handwriting, using the computer and using a television remote-control device. Addressing the tremor problems in MS patients may be significantly helpful in management of acute phase as well as rehabilitation.
Aim of the Study:
This study aimed to assess multidimension of tremors in patients with multiple sclerosis.
Research Question:
What are the multidimension of tremors in patients with multiple sclerosis?
Research design:
A descriptive exploratory design was utilized for the conduction of this study.
Setting:
The study was conducted at MS outpatient clinic at Ain Shams University Hospitals.
Sampling:
A purposive sample of comprised 150 adult patients with multiple sclerosis from previously mentioned setting. The sample size was determined considering the total number of patients (450) who had admitted during the year 2016 in the previous mentioned setting
Tools for Data Collection:
I. An interviewing questionnaire for patients with multiple sclerosis.
II. Multidimensional assessment of tremor in patients with multiple sclerosis.
Results:
The main finding of this study was summarized as follows:
Regarding demographic characteristics, 57.33% of the studied patients were aged from 20≥30years old, 70% were female and also 60.67%were married. Moreover, 32% of the studied patients had moderate education level. Also 68.67% were resident in rural area and 38.67% were worked office work.
Regarding description of tremor, 54.66% of the studied patients had tremor in right upper extremities, 84% had intermittent tremor, 61.33% had worsen tremor in the afternoon, in addition to 40% of tremor affected by stress and stressful event.
The results revealed that 93% of the studied patients suffering from feel down also 96.66% feel embarrassed and 96% feel with frustration.
The results showed that 16% of the studied patients had slight intentional tremor in upper limb and 14 % had slight intentional tremor in lower limb.
The result revealed that was significant positive correlation between tremor severity scale and age with P value = 0.00001. Also, there was highly significance relation between tremor severity scale and gender with P value =0.023 and there were significance relations between tremor severity scale and self-care with P value =0.002.
There were highly statistically significance positive correlations between self-care, productivity activities, leisure activities and other activities with P= 0.00001.
Conclusion
One half of the studied patients with multiple sclerosis had tremor in right upper extremities and less than one third of patients had postural tremor.MS relapses impact on physical ability, financial and social circumstances and also influence treatment decisions. A multidisciplinary approach to rapid-access care is likely to benefit patients and allows most relapses to be managed in the outpatient setting Finally, tremor severity scale was positively correlated with age, gender, and self-care and also there was a positive correlation between self-care, productivity activities, leisure activities and other activities.
Recommendations:
1-Health education should be given to multiple sclerosis patients with tremor on how to improve their quality of life, with more efforts to improve the awareness of the patients regarding the deep breathing and relaxation as tremor exacerbated by fatigue, stress and anxiety, caffeine and cigarette smoking
2-Patients during acute phase and after the discharge should seek counseling to help identify and treat their tremor disorders. Moreover, health care providers pay close attention to patient’s tremors during and after the acute MS phase
3-Comprehensive an instructional booklet to reduce stress, anxiety and improving patient knowledge about multiple sclerosis.
4-Tremor should be addressed in clinical visits in patients with multiple sclerosis and during rehabilitation and interventions should be tested to optimize tremor in long-term MS survivors.