Multiple Sclerosis (MS) Guide: Causes & Support Therapies
Physiotherapy
The Role of Physiotherapy
MS is a chronic inflammatory disease that impacts the brain, spinal cord, and optic nerves, which make up the central nervous system and controls everything we do. Commonly diagnosed between the ages of 20 to 40 years, rarely much earlier during childhood, or in old age. In Australia, affects three times more women than men.
There is no known single cause of MS, but many genetic and environmental factors have been shown to contribute to its development.
In MS, the body’s own immune system mistakenly attacks the protective sheath (myelin) that covers nerve fibres and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerve fibres.
There are three main types of MS
- Relapsing-remitting multiple sclerosis (RRMS) – about 85%.
- Secondary progressive MS (SPMS) – secondary phase of RRMS that can develop years to decades following the initial onset of symptoms.
- Primary progressive MS- approximately 10-15% of people with MS.
All three types differ in the extent and severity of symptoms- not everyone diagnosed with MS faces disability. And, most importantly, people with MS can live well through a range of treatments including medical management, lifestyle change, and non-drug-based complementary therapies such as physiotherapy.
The most common symptoms include fatigue, lack of coordination, pain, unsteady gait or inability to walk, dizziness, vertigo, altered mood (e.g., depression), visual disturbances, problems with sexual, bowel, and bladder function, slurred speech, and cognitive problems.
Role of Physiotherapy in the management of symptoms
The highest potential for central nervous system adaptation and recovery takes place in the early stages of the disease. Physiotherapy intervention and recommendation early after the diagnosis can reduce disability, maximise the potential for independence and reduce impact that the disease has on health and quality of life.
Research has shown that people with MS frequently reduce physical activity due to the fear of symptoms exacerbation and this can result in reconditioning. There is a strong body of evidence that exercise should be considered a safe and effective means of rehabilitation in MS patients. In addition, there is an emerging body of evidence to show that physiotherapists play a key role in managing specific symptoms of MS including pain, spasticity, and prevention of secondary complications such as contracture. Results from randomised controlled trials of exercise programs have demonstrated benefits in muscle strength, physical fitness, cardiovascular fitness, and functional capacity such as walking ability.
At Healthproof physiotherapy, we can help create customized exercise programs to suit the
individual needs, abilities, and preferences of people with MS. We can help you to:
- Alleviate fatigue by gradually increasing your functional capacity through exercise (e.g. aerobic training) so you continue to do things that you love.
- Improve balance, strength, coordination, and endurance through a combination of tailored exercises focusing on strength, core stability, and the activity of daily living tasks, such as getting in/out of bed, walking, taking stairs, etc.
- Reduce pain by gentle stretching, range of motion, strengthening, and breathing exercises.
References
Halabchi F, Alizadeh Z, Sahraian MA, Abolhasani M. Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurology 2017
Learmonth YC and Motl RW. Exercise Training for Multiple Sclerosis: A Narrative Review of History, Benefits, Safety, Guidelines, and Promotion. International J Environ Res Public Health 2021
Döring A, Pfueller CF, Paul F, Dörr J. Exercise in multiple sclerosis – an integral component of disease management. EPMAJ 2012
Heesen C, Romberg A, Gold G, Schulz K-H. Physical exercise in multiple sclerosis: supportive care or a putative disease-modifying treatment. Neurotherapeutics 2006
MS Australia Research Advocacy Cure. Retrieved January 28, 2023, from
https://www.msaustralia.org.au/what-is-multiple-sclerosis-ms/
MS PLUS Neuro Wellbeing. Retrieved January 28, 2023, from
https://www.msplus.org.au/resources/benefits-of-exercise-for-mind-and-body
Chartered Society of Physiotherapy. Retrieved February 3, 2023, from
https://www.csp.org.uk/publications/physiotherapy-works-multiple-sclerosis-ms
