Ithuluzi Lokuqapha I-MS Ukuguqulwa Kwamagciwane Okusetshenziswe Kakhulu Esifundweni
I-Expanded Status Scale (EDSS) isistimu yokulinganisa evame ukusetshenziselwa ukuhlukanisa nokulinganisa ukuqina nokuqhubeka kwe- multiple sclerosis (MS).
Ngenkathi i-EDSS inezinkinga eziningi futhi ilukhuni ukusebenzisa nokuqonda, kubalulekile ukuthi abantu abane-MS okungenani bazi nokuthi kuyasetshenziswa kanjani. Ezinye izazi ze-neurologists zizozisebenzisa ukuze zithole ukuthi i-MS yeziguli zabo ziyaqhubeka kanjani (njengokungathi ziyakhubazeka kakhulu).
I-EDSS iphinde isetshenziswe kakhulu ekuvivinyweni kwemitholampilo, kokubili ukucacisa ukuthi ubani ongabamba iqhaza kanye nemiphumela yokubika (njengokuthi ngabe i-MS yokwelapha isebenza kahle).
Indlela i-EDSS Score ebalwa ngayo
Isilinganiso se-EDSS sisekelwe ekuhlolweni kwezinzwa kanye nokuhlolwa kwezinhlelo zokusebenza (FS), eziyizindawo zesistimu enkulu yezinzwa ezilawula imisebenzi yomzimba. Lezi zinhlelo zokusebenza ziyi:
- I-Pyramidal (ikhono lokuhamba)
- I-Cerebellar (ukuxhumana)
- I-Brain stem (inkulumo nokugwinya)
- Izwela (ukuthinta nobuhlungu)
- Imisebenzi ye-bowel kanye nesinye
- Kubukeka
- Ingqondo
- Okunye (kufaka phakathi noma yikuphi ukutholakala kwezinzwa ngenxa ye-MS)
Ngemva kokuhlola lezi zindlela, i-neurologist izobe igoqa isiguli ngokusekelwe ekutholeni kwayo. Amaphesenti we-EDSS avela ku-0.0 kuya ku-10.0.
Bhala ukubuyekeza 0.0 inani Yini okusha Normal neurological exam.
1.0: Akukho ukukhubazeka, kodwa izimpawu ezincane ohlelweni olulodwa lokusebenza (FS) zikhona.
1.5: Akukho ukukhubazeka, kodwa izimpawu ezingekho ngaphansi kwe-FS ezingaphezu kweyodwa.
2.0: Ukukhubazeka okuncane ku-FS eyodwa kukhona.
2.5: Kukhona ukukhubazeka okuncane ku-FS eyodwa noma ukukhubazeka okuncane ngaphakathi kwama-FS amabili.
I-3.0: Kukhona ukukhubazeka okulinganiselwe ku-FS eyodwa noma ukukhubazeka okuncane ku-FS emithathu noma emine. Kodwa-ke, lo muntu usalokhu ehamba ngokugcwele.
3.5: Umuntu uhambela ngokugcwele, kodwa unokukhubazeka okulinganiselwe ku-FS eyodwa nokukhubazeka okuncane ku-FS eyodwa noma amabili, noma ukukhubazeka okulinganiselwe kuma-FS amabili; noma ukukhubazeka okuncane kuma-FS amahlanu.
I-4.0: Umuntu uhambela ngokugcwele ngaphandle kosizo, futhi uphezulu futhi cishe cishe usuku (amahora angu-12) naphezu kokukhubazeka okunzima. Uyakwazi ukuhamba ngamamitha angu-500 ngaphandle kokusiza noma ukuphumula.
4.5: Umuntu uhambele ngokugcwele ngaphandle kosizo, futhi uphelelwe isikhathi esingakanani nosuku. Ungakwazi ukusebenza usuku olugcwele, kodwa kungenjalo kungaba nemikhawulo yemisebenzi egcwele noma idinga usizo oluncane. Lokhu kubhekwa njengokukhubazeka okukhulu. Iyakwazi ukuhamba ngamamitha angu-300 ngaphandle kosizo.
5.0: Umuntu uyakwazi ukuhamba ngamamitha angu-200 ngaphandle kokusiza noma ukuphumula. Ukukhubazeka kuyaphazamisa imisebenzi egcwele yansuku zonke, njengokusebenza usuku olugcwele ngaphandle kwezinhlinzeko ezikhethekile.
5.5: Umuntu uyakwazi ukuhamba ngamamitha ayi-100 ngaphandle kosizo noma ukuphumula. Ukukhubazeka kuvimbela imisebenzi egcwele yansuku zonke.
6.0: Umuntu udinga ukusizwa okuqhubekayo noma okungahambisani nomunye (umoba, umkhonto noma ubhontshisi) ukuhamba ngamamitha angu-100 noma ngaphandle kokuphumula.
6.5: Umuntu udinga ukwesekwa okuhlanganyelwene ngaso sonke isikhathi (umhlanga, umkhonto noma ama-braces) ukuhamba ngamamitha angu-20 ngaphandle kokuphumula.
7.0: Umuntu akakwazi ukuhamba ngaphezu kwamamitha amahlanu ngisho nangesiza, futhi ngokuyisisekelo uvinjelwe esihlalo sabakhubazekile. Kodwa-ke, yena uhamba ngamagundane futhi uhamba wodwa futhi usebenza ngesihlalo sabakhubazekile cishe amahora angu-12 ngosuku.
7.5: Umuntu akakwazi ukuthatha izinyathelo ezimbalwa futhi uvinjelwe esihlalweni sabakhubazekile, futhi angadinga usizo lokudlulisa. Uhamba ngamasondo, kepha angadinga isihlalo esinamandla ngemisebenzi yosuku olugcwele.
8.0: Umuntu uvinjelwe ukulala embhedeni, isihlalo noma isihlalo sabakhubazekile, kodwa angase alele embhedeni usuku lonke. Uhlala egcina imisebenzi yokuzinakekela futhi esebenzisa ngokugcwele izikhali.
8.5: Umuntu uqobo uvinjelwe ukulala isikhathi eside, kepha usebenzisa ezinye izikhali ngendlela efanele futhi agcina ezinye izinto zokuzikhokhela.
9.0: Umuntu uvalelwe embhedeni, kepha usakwazi ukuxhumana nokudla.
9.5: Lo muntu akakwazi ukusiza futhi ulele embhedeni futhi akakwazi ukukhuluma ngokuphumelelayo noma adle futhi agxume.
10.0: Ukufa ngenxa ye-MS.
Izinkinga zokusebenzisa i-EDSS ye-MS
Abacwaningi kanye nochwepheshe baye baqaphela ukwehluleka okulandelayo kwe-EDSS ukuze babonise iziguli ze-MS nokuqhubeka kwabo kwesifo:
- I-EDSS ibeka ukugcizelela kakhulu ikhono lokuhamba.
- Ayinandaba nokusebenza okungaqondakali ku-MS (njengezikali eziningi ezisekelwe ekuhloleni okujwayelekile kwegazi).
- Ukubala izikolo ze-EDSS kunzima, njengoba imithetho yokukala ukutholakala kokuhlolwa kobuchopho futhi ukuguqula lezi zici esimweni sesistimu yokusebenza kuyinkimbinkimbi futhi iyinkimbinkimbi.
- Ngenxa yendlela indlela eyakhiwe ngayo (bheka amaphuzu angaphambi kwalokho), i-EDSS ayinaki ukushintsha izinguquko eziningi zomtholampilo umuntu one-MS azizwa ngayo. Ngamanye amazwi, abantu kubonakala sengathi "bagxuma" kusuka kwesinye ingxenye sezinga kuya kwesinye, kunokuba babonise ukwehla okubushelelezi.
Ngokwesichazamazwi, umehluko owodwa we-point in the score awulingani, kuye ngokuthi yikuphi esikalini uhlola. Isibonelo, ukuphuma kumaphuzu ka-8.0 kuya ku-9.0 kuyinto enkulu, njengoba kusho ukuthi umuntu uqobo uqala ukuzimela ngokuzibophezela. Ngakolunye uhlangothi, ukusuka ku-1.0 ukuya ku-2.0 kusho ukuthi umuntu akaveli ekukhubazekeni ukukhubazeka okuncane. Ngokuvamile, le caveat ingenza ushintsho ngamaphuzu kunzima ukuhumusha ezikoleni zesayensi.
Kuyini i-EDSS Ewusizo?
Kungenzeka ukuhamba emuva nangaphezulu esikalini. Isibonelo, isiguli esisebenzayo ngokugcwele nesimpawu sezinzwa singase sibe nesilinganiso se-EDSS se-1.0 isikhathi esiningi. Ukuphindaphinda kwe-optic neuritis kungahle kwenzeke amaphuzu abo kuze kufike ku-3.0, kuze kube yilapho bephathwa noma izimpawu zizishiya zodwa. Bese bebuyela emuva ku-1.0 (noma i-1.5 uma kunezinye izimpawu eziqhubekayo).
Nakuba izinzwa eziningi ze-neurologists zisebenzisi ngokuqondile iziqephu ze-EDDS ukuqapha iziguli, abanye bayisebenzisela ukunquma ukuthi kufanele bathathe isinyathelo njengokuthi ukwelashwa kwe-Solu-Medrol noma ukwelashwa ngokomzimba kuqinisekisiwe.
Izwi elivela
Ngenkathi ufunda yonke imininingwane kanye nama-nuances we-EDSS cishe akufanelekile isikhathi sakho, kuhle ukuthi manje uyakwazi ukuthi i-EDSS iwuphi lapho ufunda ekutadisheni kwe-MS, noma uma uzwa isazi sakho sezinzwa sithi. Kungase futhi kunikeze induduzo kwabanye benu, bazi ukuthi kunendlela ejwayelekile yokuhlukanisa ukukhubazeka ku-MS.
Imithombo:
Meyer-Moock S., Feng YS., Maeurer M., Dippel FW., & Kohlmann T. Ukubuyekezwa kwezincwadi zesistimu nokuhlolwa okusemthethweni kwe-Expanded Status Scale (EDSS) kanye ne-Multiple Sclerosis Functional Composite kwiziguli ezine-multiple sclerosis. BMC Neurol . 2014 Mar 25; 14: 58.
I-National MS Society. Ama-Functional Systems Scores (FSS) ne-Extended Status Status Scale (EDSS).