Prevalence of oedema of the lower limbs in multiple sclerosis patients: a vascular and lymphoscintigraphic study

Abstract

The aim of the study was to evaluate the frequency of oedema of the lower limbs in multiple sclerosis (MS) patients utilizing a multidisciplinary approach. A total of 205 patients with definite MS were included in the study. Seventy-five were male and 130 female, with a mean age of 50.53, mean Expanded Disability Status Scale (EDSS) score of 5.27 and mean disease duration of 16.6 years. Seventy-one patients had a relapsing-remitting (RR) disease course, 85 were secondary progressive (SP) and 49 were primary progressive (PP). Ninety-three patients (45%) showed oedema at the examination. EDSS, disease duration and disease course, but not gender, were statistically different between oedema and non-oedema patients. Out of 93 patients with oedema, 69 agreed to undergo a vascular examination. Of 69 patients, 45 (65.2%) had a CEAP score (specific rating scale for oedema) of 3 (presence of oedema) and 24 (34.8%) had a score of 4 (presence of a trophic disorder). Out of 69 subjects, 33 agreed to undergo a lymphoscintigraphy, which was normal in only 29 extremities out of 66. Lower limb oedema is common in MS patients, especially in those with reduced mobility. Early screening is advised in patients with an elevated EDSS.

Chronic oedema: a prevalent health care problem for UK health services

“…Attempts to define the prevalence of CO in the general population are sparse , and most previous studies have relied on information that has been obtained from specific patient groups . This study shows that the point prevalence of CO in a heterogeneous health service population is high and comparable to or greater than the prevalence of other serious long‐term conditions, such as stroke.…”

“…To date, the focus of previous research has been to estimate prevalence in specific patient groups ; however, as CO is the final common pathway for many conditions, it is important that prevalence is examined amongst heterogeneous populations. One earlier study of a mixed London‐based population estimated the prevalence of CO to be 1·33 per 1000 .…”

“…To date, the focus of previous research has been to estimate prevalence in specific patient groups (5,6); however, as CO is…”

Research on lower extremity health in patients with multiple sclerosis: a systematic scoping review

“…The research on lower extremity muscle strength concentrated on analysing the muscle performance and capacity of the lower extremities during exercise or resistance training. There were single studies focusing on foot sensation, [ 50 ] foot vibration perception, [ 50 , 60 ] neuropathic foot pain, [ 60 ] foot deformities, [ 75 ] lower limb oedema [ 80 ] and foot sudomotor function [ 60 ].…”

“…This kind of information could be used as the basis for future interventions and technological innovations. [46,47,51,56,62,82] Impaired balance [48,50,51,67] Walking dysfunction [44,54,59,66,67,73,78,79,82,84] Decreased pressure sensation [50] Decreased vibration sensation [50,60] Sudomotor dysfunction [60] Oedema [80] Pes cavus [75] Claw toes [75] Spasticity [68,81] One important aspect of lower extremity health is foot self-care, but there is limited evidence of how patients with MS manage this. Therefore, it is important to identify potential gaps in foot care knowledge and habits among patients with MS, which could be done by using, for example, information technology for communication.…”