Multiple sclerosis is an abnormal immune response of body’s nervous system that causes it to attack the central nervous system, which includes the brain, spinal cord, and optic nerves. When the immune system attacks these nerves, they become damaged and scarred, causing a variety of secondary symptoms, most notably feelings of fatigue, walking difficulties, numbness and overall weakness. In the early 1970s, it was felt that patients should avoid physical exertion because it was thought to be too taxing for patients with this disease to handle, but a growing body of evidence now suggests that rehabilitative physical therapy could relieve some of the discomfort and perhaps even slow the progression of the disease. It is thought that by maintaining good muscle strength, patients suffering from MS can combat the inflammation that comes with the neurological damage caused by the disease and remain independent longer by building endurance.
MS is a challenging disease to treat with physical therapy because there are a number of physical factors that make exercising more difficult, including elevated core body temperature, muscle deconditioning due to inactivity, depression, and even some drug therapies used to treat the disease. An early rehabilitation evaluation can be very beneficial in keeping the disease progressing slowly. Rehabilitative evaluations determine a person’s physical ability and will often include assessments of a patient’s gait (walk), fatigue survey, balance assessments, a timed up and go, and assessments of their ability to be functionally independent.
After the patient is assessed, the physical therapist will usually set both short term and long term goals and come up with an exercise regimen for the patient. Some of this plan will involve the patient coming in to the rehab office or meeting with the therapist regularly in their own home. Guided sessions would include exercises that build and maintain core stability, increase aerobic fitness, and low-level resistance training. Additionally, the therapist would discuss recommendations for individual fitness, most commonly, just getting about 150 minutes of walking in a week. Usually if exercise programs are suggested they’re not intensive, but low-intensity like water exercises, gentle yoga, or tai chi.
These regimens are usually implemented over a series of months and then patients are re-evaluated. Patients have reported increases in mood, muscle fitness, strength & mobility, bowel and bladder functions, and self-esteem. Improvements in sleep and the prevention of weight gain that can put unnecessary stress on a MS patient’s system have also been reported. Through exercise, MS patients feel more empowered over their chronic symptoms, improving their quality of life in the present and for the future.