Multiple Sclerosis
Multiple Sclerosis also known as MS is a chronic and inflammatory disease which affects the central nervous system.
MS is characterised by scars which appear throughout the Central nervous system
There are three Types of MS:
Relapsing-remitting MS (RRMS) which is the most common type of MS, in RRMS new symptoms appear or existing symptoms worsen, this will be followed by a partial or complete recovery which is followed by a relapse
Primary Progressive MS (PPMS) in which symptoms gradually worsen with no seperate attacks
Secondary Progressive MS (SPMS), most with RRMS will eventually develop SPMS where symptoms start to worsen independent of relapse
Causes
The cause of MS is currently unknown
The majority of people diagnosed with MS are between 20-40 years old age
MS is more common in women than men
Signs & Symptoms
The signs and symptoms of MS will vary depending on the location of the scars, some possible signs and symptoms include;
Muscle weakness
Spasms
Decreased co-ordination
Decrease in balance
Fatigue
Heat sensitivity
Incontinence
Decrease in cognitive funtion
Poor vision
Pins + needles sensation
Decrease in function of legs and arms
Speech difficulties
Differential Diagnosis
Diagnosis of MS will be confirmed through a medical specialist prior to commencements with PROmotion, some differential diagnosis your medical specialist may explore include:
Spinal cord neoplasms
Acute disseminated encephalomyelitis (ADEM)
Transverse myelitis
Infarction of the spinal cord
Vasculitis
Radiation myelitis
Progressive multifocal leukoencephalitis
PROmotion Assessment and outcome measures
Initial diagnosis and plan management will be completed with medical specialist
An assessment with Exercise Physiologist will include a medical PAR-Q, medical history, current signs and symptoms, attack history, current physical activity levels, short and long term goals and blood pressure
Based on individual goals further assessment of Body composition (height, weight, body girths), Cardiovascular fitness test, muscular strength & endurance, flexibility, balance and range of movement
Re-test and a visit of goals will occur every 6-8 weeks or when required if symptoms change
How to Manage
A individual exercise program designed around specific goals and possible barriers
Options of Group, individual or home exercise setting
Education surrounding exercise safety and attacks
Management may also include referral to other relevant allied health professionals for a holistic approach
References
Amiri B, Sahebozamani M, Sedighi B. The effects of 10-week core stability training on balance in women with multiple sclerosis according to Expanded Disability Status Scale: a single-blinded randomized controlled trial. Eur J Phys Rehabil Med. 2019;55(2):199-208. doi:10.23736/S1973-9087.18.04778-0
Sangelaji B, Kordi M, Banihashemi F, Nabavi SM, Khodadadeh S, Dastoorpoor M. A combined exercise model for improving muscle strength, balance, walking distance, and motor agility in multiple sclerosis patients: A randomized clinical trial. Iran J Neurol. 2016;15(3):111-120.
Halabchi F, Alizadeh Z, Sahraian MA, Abolhasani M. Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurol. 2017;17(1):185. Published 2017 Sep 16. doi:10.1186/s12883-017-0960-9