Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system. It is characterized by chronic inflammation, demyelination, gliosis and neuronal loss. Physical therapy (physio) plays an essential role in keeping a person suffering from MS active and functioning within their community
The aim of physiotherapy is to help the patient:
- Re-learn and maintain available voluntary control of motor functions
- Re-learn and maintain postural ability
- Incorporate treatment techniques into usual way of life
- Inhibit abnormal tone of patient
- Prevent abnormal movements
- Stimulate sensory and perceptual experience
An MS physio assessment needs to focus on posture, movement, and function and recognize when the patient’s performance is limited by fatigue, pain or other factors. An individualized program should then be established for the patient that they can perform at home and is provided to the patient as written instructions. Education about MS is recommended so that patients can learn to manage their programs independently.
Exercise is the essential element of MS physio. It is beneficial at multiple levels and plays an important role in controlling symptoms of the disease. Exercises should be appropriate to a patient’s strengths and weaknesses. The best amount of exercise (intensity, frequency and duration) for treatment will depend on the activities and the extent of participation of the patient. Exercise is considered a safe, effective means of rehabilitation and also has a positive effect on mood and enhances quality of life.
The overuse of therapeutic corticosteroids and a patient’s inactivity from fatigue and weakness can result lead to osteoporosis and the risk of pathological fractures. Weight-bearing exercises can help to prevent this and are beneficial. A resistance training program is also recommended to help maintain bone and muscle mass.
Neuromuscular techniques when carried out regularly and with sufficient intensity, have also been shown to help with a patient’s MS symptoms. Aquatic exercise programs also have a positive effect on patients suffering from progressive multiple sclerosis. Swimming and other aquatic activities improve general health, energy levels and mental health while also resulting in social interaction with others. Because of the reduced impact of gravity when a person is submerged in water, aquatic training is can be used by patients with severe paresis of the lower extremities to perform standing and moving exercises. Studies show combining aquatic therapy with conventional physical therapy for MS patients shows beneficial effects. Aerobic exercise, at low to moderate intensity, results in the improvement of aerobic fitness and reduction of fatigue in MS patients that are affected with mild or moderate disability and is a core MS physio treatment approach.
