Multiple sclerosis is a neurological disease that can progress in different forms. It is chronic and progressive. There are recurrent attacks or the disease takes a gradual course.
It is an autoimmune reaction against the body’s own myelin – the insulating layer of the nerves. The inflammation can destroy the myelin sheaths around the nerves and form so-called plaques. This can occur centrally in the brain but also at the peripheral nerves and lead to neurological deficits.
Sensitivity disorders, sensory disturbances, muscle weakness or ataxia (uncontrolled movements), but also bladder dysfunction or impairment of the optic nerve are possible. In addition to drug therapy, physiotherapeutic treatment is of great importance in MS in order to limit the loss of function for as long as possible or to develop compensation mechanisms. If you would like to know more about the signs of multiple sclerosis, we recommend our page on: Symptoms of Multiple Sclerosis Another disease of the peripheral nerves is polyneuropathy. If you would like to find out more about this, please read this article:
- Physiotherapy for neuropathy or causes of polyneuropathy
Treatment
Patients suffering from multiple sclerosis often receive a prescription for “physiotherapy (CNS) on a neurological basis”. This can also be prescribed as a long-term prescription outside of the normal case. There are various therapy concepts that the doctor can prescribe and according to which the treatment is then structured.
Classical examples are Vojta therapy, PNF or Bobath. In Vojta therapy, various precisely defined reflex points are activated while the patient is in a prescribed starting position. The activation can be used to recall certain movement patterns that can cause physiological muscle tone and improve spasticity or ataxia.
Goals
The overall goal of physiotherapy for MS patients is to improve or maintain the patient’s ability to cope with everyday life independently, to improve and maintain mobility. For this purpose, the increase of proprioception is aimed at. Proprioception is the self-perception that is mediated by sensors in skin, tendons, ligaments, muscles and joints.
Good proprioception often improves spasticity, and balance problems can also be corrected. The latter is also a goal of treatment in MS: improving balance and coordination, for example through gait training. Stability is also an important focus that needs to be improved in physiotherapeutic treatment.
If the patient can keep the trunk stable, this is often followed by a change in tone. Since MS also causes spasticity, ataxia or paralysis, it is necessary to regulate the tone of the trunk by means of specific neurological techniques in order to ensure normal, physiological muscle function. Paralysis or spasticity also causes orthopaedic problems, as joints are no longer used physiologically.
Here it is important to keep the joints flexible and functional by mobilization and stretching. The therapy for MS patients is also very individual and can be adapted to the patient, e.g. pelvic floor training can be integrated, transfers e.g. from sitting to standing position or other contents of daily life can be improved in a targeted manner. The patient should be included in the goal setting process.
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