NEUROLOGICAL PHYSIOTHERAPY

Multiple Sclerosis

Multiple Sclerosis

Multiple sclerosis (MS) is classified as a inflammatory demyelinating disease due to the disruption of the protective sheath around the nerve (myelin sheath). The myelin sheath is essential for the transmission of electrical impulses and important for many functions of the body. Damage to this nerve covering can lead to a diversity of symptoms. MS affects the brain and spinal cord.

Multiple Sclerosis

It is estimated that there are at least 8000 people with Multiple Sclerosis (MS) in Ireland.

Symptoms are diverse and can vary significantly from one person to another. They are often unpredictable and disruptive to daily living and for this reason it is a very challenging condition that requires input from all team members.

Multiple Sclerosis Treatment 

Drug therapies can help MS. There are essentially two treatment options:

Symptomatic drug therapy which ease or relieve symptoms eg limb stiffness, bladder problems

And

Disease modifying drugs which have a primary impact on the disease process, eg betaferons, but which to date are only partially effective.

Multiple Sclerosis Symptoms

Typically a person with MS will present with an extensive and varied symptom pattern and may complain of some of the following:

  • muscle weakness,
  • muscle spasms,
  • fatigue,
  • spasticity (stiffness),
  • sensory disturbances
  • visual loss,
  • balance impairment,
  • pain
  • disturbance of bladder control
  • most importantly disruption to functional activities.

Many of the above mentioned symptoms can respond to Physiotherapy input. Early intervention by a skilled Neurophysiotherapist will identify physical impairments, their impact on function and establish an appropriate long-term management plan.

At the Dublin Physiotherapy clinic a comprehensive assessment will include a detailed history and physical assessment. From this key impairments and potential problems are identified. A rehabilitation program is devised specific to your needs Management will vary for each person and may include any or some of the following:

  • Monitoring your condition. Monitoring is essential if changes to management and treatment planning is required. Any changes are  identified through a detailed history, and re-evaluation of assessment markers.
  • Providing guidance on management of different aspects of the condition eg fatigue,
  • Providing active intervention on a regular basis as required. Treatment will combine hands on work with movement re-education and exercise prescription.
  • Provision of a tailored exercise program to address specific problems eg weakness, stiffness, strength, fitness. This can often be carried out at home or incorporated into a gym regime under our guidance.
  • A short burst of treatment. This could take the form of 6 – 8 sessions and can be very valuable when specific problems need addressing (eg strength, pain) or if there been a deterioration in symptoms.
  • Regular communication with other professionals eg Occupational therapist, speech therapist, orthotist, podiatrist ( shoes inserts), doctors, nurse specialists, family and carers is essential for continuity of care and optimal management of symptoms.
  • Ordering and provision of equipment or referral to the appropriate professional where specific appliances are made for individual requirements eg orthotics.

Given the progressive nature of the condition it is common practice that we would see an individual for many years but often on an intermittent basis when issues arise. The frequency of visits will really depend on the extent and pattern of symptoms, your goals and what we as clinicians can achieve through active intervention.

A recent profiling study of people with M.S. in Ireland was undertaken at the request of M.S. Ireland, whose members valued Physiotherapy as an integral part of their management but complained of the lack of input.  The findings were surprising and supported their complaint that the amount of Physiotherapy they received was low.

A larger study is currently underway in Ireland looking at the importance and value of exercise with Multiple sclerosis. “Getting the Balance Right” programme which you may have heard of or taken part in.  The results are extremely positive and support evidence that structured exercise programs can improve many of the physical impairments that we as physiotherapists treat – weakness, balance, functional limitations.

At Dublin physiotherapy Clinic exercise programs can be specifically devised, monitored and re-evaluated as needed. They are varied and structured to address core elements of conditioning and fitness:

Multiple Sclerosis
  • strength
  • flexibility
  • coordination
  • balance
  • core (abdominal) stability
  • postural alignment
  • cardiovascular fitness

The following sites provide further valuable information on Multiple Sclerosis

www.ms-society.ie

www.mssociety.org.uk

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