Multiple Sclerosis (MS) is a chronic disease that affects the central nervous system.
There is damage to the protective sheath (known as myelin) that surrounds the nerve fibres in the brain and spinal cord. This damage causes scars, or lesions, in the nervous system, thereby disrupting the communication between the brain and body.
MS usually starts with mild symptoms that may or may not get worse over time. Symptoms depend on which part of the central nervous system is affected and how much damage has occurred. The most common symptoms are:
- Lack of body control — muscle spasms, weakness, loss of coordination and balance
- Fatigue and sensitivity to heat (a hot day or a hot bath, or even a hot cup of tea, can make symptoms worse)
- Other nervous symptom problems — including vertigo, pins and needles in hands and feet, dizziness, neuralgia and problems with eyesight (damage to the optic nerve)
- Continence problems — including bladder incontinence and constipation
- Changes in memory, concentration, reasoning, emotions, or in mood (such as depression)
It is possible for people to be mostly symptom-free for most of their life, and some may experience low-severity symptoms like numbness or weakness in their hands or feet. Others may experience chronic symptoms and unfortunately, lose their ability to activate their muscles altogether requiring the use of a wheelchair. The symptoms of MS vary widely from person to person. MS is unpredictable.
Regardless of neurological status, all individuals with MS can enjoy the physical and emotional benefits of rehabilitation.
Physiotherapy for MS
Our passionate and caring Physiotherapists predominantly help MS patients maximise their physical capacity, remain active and manage their symptoms.
We do exercise rehabilitation to improve:
- Range of motion
- Strength through resistance training
- Fatigue/cardiovascular conditioning
The exercises we would prescribe vary depending on the severity and functional level of the person.
Occupational Therapy for MS
Total Health Physio has dedicated Occupational Therapists who provide home visits to individuals with MS.
Our OTs work with the patient to ensure their home is a safe environment for them and they prescribe assistive equipment to help with activities of daily living.
Our OTs help train activities of daily living, including:
- Using the bathroom safely
- Cooking, cleaning gardening
- Accessing their property & community
- Trialling & reviewing assistive equipment or making home modifications
We also help the person plan how to manage their fatigue levels so they can live at home safely and independently!
Multiple Sclerosis FAQ
What exercises will your Physiotherapists prescribe for MS patients?
For people who are high functioning, we would focus on building strength in the core and lower limbs, to help them with the overall stability of their body and muscles.
Activation of the quadriceps is imperative for walking, getting out of bed, for transitioning from sitting to standing. Quadriceps specific exercises such as squats and lunges would be incorporated as part of the rehabilitation. We can also use muscle stimulators to help activate the muscle.
For patients experiencing muscle spasms, we would perform soft tissue massage to help ease the muscle spasm as well as a technique called Passive Neurological Facilitation (PNF), which is a type of exercise to help stretch and relax the muscles.
Our Physiotherapy is delivered through Private Home Visits, and the frequency is dependent on the individual’s goals and expectations.
What are Total Health Physios's considerations for treating MS patients?
As suggested, MS is a condition of the Central Nervous System. The CNS is responsible for the correct function of the musculoskeletal system, the vestibular system, pulmonary system as well as the autonomic system. So, MS can cause dysfunction in varying ways from:
- Muscle weakness
- Muscle co-contraction (when two or more muscles contract)
- Extensor synergy (pattern of muscle recruitment) – namely affects gait
- Impairments of motor sequencing and coordination
The neurological component of MS means that Physiotherapists will work on the mechanical aspect (strength and range of motion), combined with the neurological component (integration of the senses and how this coordinates motor output).
An example of this would be understanding the sensation an individual has in their feet and how they move to balance accordingly. We may use the Berg Balance Scale or Forwards/Backwards weight shifting measures to benchmark this.
This also means that we would create a rehabilitation plan that is individualised to that person’s specific needs. This includes assessing the condition holistically (i.e. asking about sleep, mood, appetite etc) and working to improve all facets.
At Total Health Physio, our values are Trust, Compassion & Care and our expert Physiotherapists and Occupational Therapists help people achieve amazing functional outcomes!
What do your Occupational Therapists focus on when treating MS?
For MS patients, a large emphasis would be on upper extremity function, such as hand function (namely building grip strength) and trunk control, which ultimately helps with the ability to reach.
Is Total Health Physio a suitable provider for all MS patients?
Total Health Physio works with older adults and the elderly living with physical and/or neurological conditions.
If the patient’s condition is outside of our scope of practice, we will refer onwards.
As an example, bladder control can be an issue, and we know very specific incontinence physiotherapists who are experienced with improving bladder control. We also have relationships with amazing Speech Pathologists to help improve issues with speech and swallowing.