Isixhobo sokujonga i-MS Izifo eziqhubekileyo zisetyenziswe kakhulu kwiSifundo
I-Expanded Status Scale Scale (EDSS) yinkqubo yokulinganisela esetyenziswa rhoqo ekuhleleni nasekumiseni ukunyaniseka nokuqhubela phambili kwe- multiple sclerosis (MS).
Ngelixa i-EDSS ineentsilelo ezininzi kwaye iyanzima ukuyisebenzisa nokuqonda, kubalulekile ukuba abantu abane-MS besazi ukuba yintoni kunye nendlela esetyenziswa ngayo. Ezinye izazi ze-neurologists ziya kusebenzisa ukucacisa indlela i-MS yabo yezigulane eziqhubela phambili ngayo (ngathi ingaba zikhubazeke ngakumbi).
I-EDSS iphinda isetyenziswe ngokubanzi kwizilingo zonyango, zombini ukuchonga nabani abanokuthatha inxaxheba kunye neziphumo zokunika ingxelo (ngathi ingaba unyango lwe-MS lusebenzayo).
Indlela i-EDSS Score ibalwe ngayo
Umgangatho we-EDSS usekelwe ekuhlolweni kweengqondo kunye novavanyo lweenkqubo zokusebenza (FS), eziyimimandla yenkqubo ye-nervous central elawula imisebenzi yomzimba. Ezi nkqubo zisebenza:
- IPramidal (ukukwazi ukuhamba)
- Cerebellar (ulungelelaniso)
- Isibongo seBongo (intetho nokugwinya)
- Uthando (uthinte kunye nentlungu)
- Imisebenzi yobunzima kunye nekhanda
- Ezibonakalayo
- Yengqondo
- Olunye (luquka nayiphi na enye i-neurological findings ngenxa ye-MS)
Emva kokuvavanya ezi nkqubo, i-neurologist iya kugosa isigulane esekelwe kwiziphumo zakhe. Amanqanaba e-EDSS ukusuka kwi-0.0 ukuya kwi-10.0.
I-0.0: Uvavanyo oluqhelekileyo lwe-neurological.
1.0: Akukho ukukhubazeka, kodwa iimpawu ezincinci kwinkqubo eyodwa yokusebenza (FS) zikhoyo.
1.5: Akukho ukukhubazeka, kodwa iimpawu ezincinci kwii-FS ezingaphezulu kweyodwa.
2.0: Ukukhubazeka okufutshane kwi-FS enye.
2.5: Kukho ukukhubazeka kancinane kwi-FS enye okanye ukukhubazeka okufutshane kwi-FS ezimbini.
I-3.0: Kukho ukukhubazeka ngokuthe ngqo kwi-FS enye okanye ukukhubazeka kancinane kwi-FS emithathu okanye emine. Nangona kunjalo, loo mntu usengumgqwelise ngokupheleleyo.
I-3.5: Umntu uyazigulisa ngokupheleleyo, kodwa unokukhubazeka ngokulinganayo kwi-FS enye kunye nokukhubazeka kancinane kwi-FS enye okanye ezimbini, okanye ukukhubazeka okulinganayo kwi-FS ezimbini; okanye ukhubazeko obuthathaka kwi-FS emihlanu.
I-4.0: Umntu uyazigqwelisa ngokupheleleyo ngaphandle kokuncediswa, kwaye iphezulu kwaye ininzi malunga nemini (iiyure eziyi-12) nangona ukhubazeka kakhulu. Unako ukuhamba ngeemitha ezingama-500 ngaphandle kokunceda okanye ukuphumla.
I-4.5: Umntu uhamba ngokugqithiseleyo ngaphandle kokuncediswa, kwaye uphakamise kwaye uninzi malunga nosuku. Unako ukusebenzela usuku olupheleleyo, kodwa mhlawumbi unemiqobo yemisebenzi epheleleyo okanye ufuna uncedo oluncinci. Oku kuqwalaselwa ngokukhubazeka okukhulu. Unako ukuhamba ngamamitha angama 300 ngaphandle koncediso.
5.0: Umntu uyakwazi ukuhamba ngeemitha ezingama-200 ngaphandle kokunceda okanye ukuphumla. Ukukhubazeka kubangela imisebenzi epheleleyo imihla ngemihla, njengokusebenza usuku olupheleleyo ngaphandle kwemigangatho ekhethekileyo.
5.5: Umntu uyakwazi ukuhamba ngamamitha angama-100 ngaphandle kokuncediswa okanye ukuphumla. Ukukhubazeka kuvimbela imisebenzi epheleleyo yemihla ngemihla.
6.0: Umntu udinga uncedo olusisigxina okanye olusisigxina unilateral (inqatha, i-crutch okanye i-brace) ukuhamba ngeemitha ezili-100 kunye okanye ngaphandle kokuphumla.
6.5: Umntu ufuna ukuxhaswa ngamazwe onke (inqana, i-crutch okanye i-brace) ukuhamba ngeemitha ezili-20 ngaphandle kokuphumla.
7.0: Umntu akakwazi ukuhamba ngaphaya kweemitha ezintlanu nangona uncedo, kwaye iyancitshiswa kwisihlalo sabakhubazekile. Nangona kunjalo, unamavili kunye nokutshintshwa kwedwa kwaye usebenza kwisihlalo sabakhubazekile malunga neeyure ezili-12 ngosuku.
7.5: Umntu akakwazi ukuthatha amanyathelo ambalwa kwaye ukhawulelwe kwisihlalo sabakhubazekile, kwaye unokufuna uncedo lokudlulisa. Unamavili ngamavili, kodwa angadinga isitulo esinokuhamba ngemisebenzi yemini epheleleyo.
8.0: Umntu unqunyelwe ukulala embhedeni, isihlalo okanye isitulo sabakhubazekile, kodwa unokube esethulwini emini. Uhlala enomsebenzi wokunyamekela kwaye usebenzise ngokubanzi ukusebenzisa izixhobo.
8.5: Umntu uvumelekile ukulala ixesha elininzi lomhla, kodwa usebenzisa ukusetyenziswa kakuhle kweengalo kwaye ugcina imisebenzi ethile yokuzinakekela.
9.0: Umntu uhlala elele, kodwa usakwazi ukuthetha kunye nokutya.
9.5: Umntu akanakuncedwa ngokupheleleyo kwaye ulala phantsi kwaye akakwazi ukuthetha ngokufanelekileyo okanye adle aze agqibe.
10.0: Ukufa ngenxa ye-MS.
Iingxaki zokusebenzisa i-EDSS ye-MS
Abaphandi kunye neengcali baye baqaphela izi mpazamo ezilandelayo ze-EDSS ukubonisa izigulane ze-MS kunye nenkqubela yabo yesifo:
- I-EDSS igxininisa kakhulu ukukwazi ukuhamba.
- Ayinakuqonda ukungaxilisi kwengqondo kwi-MS (njengamanqanaba amaninzi esekelwe ukuhlolwa kwe-neurological standard).
- Ukubala amanqaku e-EDSS kunzima, njengoko imigaqo yokwenza izinga lokufumana iziphumo kwiimvavanyo ze-neurological and translating these into scores in system function function are ambiguous and complex.
- Ngenxa yendlela indlela eyenziwe ngayo (jonga amanqaku angaphambili), i-EDSS ayikhathazi kwiinguqu ezininzi zekliniki eziza kuba nomntu onama-MS. Ngamanye amagama, abantu babonakala 'bexhuma' ukusuka kwelinye inxalenye yesikali ukuya kwesinye, kunokuba babonise ukuhla kwehla.
Ngokwenguqulelo, ukuhlula kwento enye kumanqaku akulingani, kuxhomekeke kwimeko apho uhlola khona. Ngokomzekelo, ukuphuma kumanqaku angama-8.0 ukuya ku-9.0 yinto enkulu, njengoko kuthetha ukuba umntu uqobo uvela ekubeni usebenza ngokuzimeleyo ukuya kulala. Ngakolunye uhlangothi, ukusuka kwi-1.0 ukuya kwi-2.0 kuthetha ukuba umntu akayikukhubazeka ukukhubazeka. Ngokubanzi, le caveat ingenza utshintsho kumanqaku kunzima ukutolika kwizifundo zesayensi.
Kufuneka nini i-EDSS?
Kunokwenzeka ukuhamba emva nangaphezulu kwinqanaba. Ngokomzekelo, isigulane esisebenzayo ngokupheleleyo esinempawu zengqondo sinokufumana amanqaku a-EDSS ama-1.0 amaninzi kwixesha. Ukuphindaphindiweyo okubandakanya i- optic neuritis kungaphula amanqaku abo ukuya kuma-3.0, de kube baphathwe okanye iimpawu zibuyiselwe zona. Baya kubuyela emva kwe-1.0 (okanye i-1.5 ukuba kukho ezinye iimpawu eziqhubekayo).
Nangona amaninzi eengxaki ze-neurologists abasebenzisi ama-EDDS amanqaku ukubeka iliso kwizigulane, abanye basebenzise ukucacisa ixesha lokuthatha isenzo ngathi ukuba unyango lwe-Solu-Medrol okanye unyango lomzimba lufanelekile.
ILizwi
Ngoxa ufunda zonke iinkcukacha kunye neenkcukacha ze-EDSS akunakulungeleli ixesha lakho, kuhle ukuba ngoku unokwazi ukuba yi-EDSS xa uyifunda kwisifundo se-MS, okanye xa uva i-neurologist yakho ithi. Inokunika nokuthuthuzela kwabanye, ukwazi ukuba kukho indlela eqhelekileyo yokuhlukanisa ukukhubazeka kwi-MS.
Imithombo:
I-Meyer-Moock S., i-Feng YS., I-Maeurer M., i-Dippel FW., Ne-Kohlmann T. Ukuphononongwa ngolu hlobo lwencwadi kunye novavanyo oluchanekileyo lwe-Expanded Status of Scal Status Scale (EDSS) kunye ne-Multiple Sclerosis I-Functional Composite kwizigulane ezine-multiple sclerosis. BMC Neurol . 2014 Mar 25; 14: 58.
National Society of MS. IiNkqubo zeeNkqubo eziSebenzayo (FSS) kunye neNqanaba loKhubazeka kweNqanaba loKhubazeka (EDSS).