title: Functional treatments in multiple sclerosis.
abstract: OBJECTIVE
  This review focuses on recent advances in the understanding and management of symptoms and dysfunctions associated with multiple sclerosis (MS).
  
  
  RESULTS
  A broad spectrum of dysfunctions associated with MS are under investigation. Research published in the past year and a half addresses gait dysfunction, exercise training, fatigue, bowel/bladder and sexual dysfunction, and sleep disruption. Functional electrical stimulation and strength training have been validated for improvement in gait and motor function. Exercise training has been shown to benefit mood and quality of life scores and to reduce circulating inflammatory cytokine levels. Fatigue remains a challenging problem with incremental improvements in understanding of underlying causes and effective drug therapies offered by recent work. Treatment of bowel, bladder and sexual dysfunction utilizing a variety of modalities has been investigated with some progress.
  
  
  CONCLUSIONS
  In the absence of treatments to reverse neurologic injury due to MS, effective symptom management and functional improvement remain essential to mitigate disability and maintain quality of life. Basic research, as well as controlled clinical trials, in this realm offers promising insights and solutions.
authors: Department of Neurology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-8806, USA.
authors: Ardith M
authors: AM
authors: Courtney
authors: Wanda
authors: W
authors: Castro-Borrero
authors: Scott L
authors: SL
authors: Davis
authors: Teresa C
authors: TC
authors: Frohman
authors: Elliot M
authors: EM
authors: Frohman
mesh_terms: D004599:Electric Stimulation Therapy; D005081:Exercise Therapy; D005221:Fatigue / Q000209:etiology / Q000628:therapy; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D009431:Neural Conduction / Q000502:physiology; D009483:Neuropsychological Tests; D012890:Sleep / Q000502:physiology; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000628:therapy