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

  1. 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

  2. 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.

  3. 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