Motor rehabilitation in multiple sclerosis is a very important part of symptomatic treatment as it allows you to improve or maintain fitness. Apart from speech therapy, ergotherapy and sociotherapy, it is an inseparable element of the patient's independence.
MS rehabilitationplays a big role.Multiple sclerosis(MS - sclerosis multiplex) is a disease of the central nervous system. It develops when there is damage to the myelin coating that covers every nerve fiber - then information in the central nervous system is transmitted more slowly, distorted or its transmission is blocked.
MS is a disease that is slightly different for everyone. Therefore, the rehabilitation program should be developed individually for each individual, but always take into account the specificity of the disease and that the patient does not overtrain.
In patients with MS, motor rehabilitation is based on the phenomenon of neuroplasticity, which means that in the event of damage to the central nervous system, it can create new nerve connections, and this gives a chance to restore lost body functions.
Which exercises?
Motor rehabilitation should be started as early as possible, right after the diagnosis of the disease - after the exacerbation phase, and should be carried out, even when the symptoms have receded, in order to build a base, basis for physical fitness and motor coordination for the future and introduce systematic training when it is not aggravating. Systematic exercise and physical therapy treatments help you stay fit for longer and protect yourself from contractures. Multiple sclerosis patients should do different types of exercise. Recommended:
- stretching exercises, improving muscle flexibility, strength and joint mobility,
- balance exercises that will help you to keep your balance and therefore prevent falls,
- coordination exercises that allow you to control the smoothness of movements,
- dynamic exercises that increase muscle strength,
- breathing exercises - strengthening the respiratory system and facilitating relaxation.
During the rehabilitation of people with MS, remember that weight-bearing exercises should be performed in a lying or sitting position so that the patient does not get tired too quickly. We start with a few repetitionsexercise, and then extend the training time. Dynamic exercises should be intertwined with breathing and relaxing exercises so that the patient not only does not get tired, but also does not overheat, as this negatively affects his condition. When the first signs of overtraining appear (shortness of breath, sweating, headaches and muscle aches, pulsation in the temples, redness or soreness of the skin, drowsiness), training must be discontinued. The sick person may get tired, but only to the limit of their efficiency. Too intensive training may not only discourage exercise, but also contribute to another relapse of the disease. That is why breaks and regeneration after training are important.
ImportantWho shouldn't exercise?Rehabilitation should not be carried out when the disease becomes acute, when there is inflammation and increased temperature, when it comes to circulatory failure or disturbance of consciousness. Exercises should also not be performed by people suffering from disease.
Connected cookware
Spasticity, i.e. increased muscle tension in the arms and legs, is a serious problem for patients and a big challenge for physiotherapists. It's the same with contractures. Both ailments have a negative impact on physical fitness because they cause pain and immobilize the limbs in a flexion position. If the patient suffers from muscle spasticity and contractures, exercise should be scheduled when the painkillers and muscle relaxants are most active. Relieving spasticity involves relaxing the affected muscles and strengthening specific muscle groups that help restore natural movement. Eliminating spasticity helps to prevent contractures. In order to soothe them or prevent them from developing more, stretching, dynamic and relaxation exercises are performed. Exercising in the water is very helpful. The treatment may be complemented by massage and electrotherapy. The spasticity of the muscles of the lower limbs is often helpful, because it is possible to walk or stand upright despite large paresis. Paradoxically, if the excessive muscle tension is overcome, the patient may stop walking, and it will also be impossible to stand upright. In advanced lesions, patients can be injected with botulinum toxin. Surgical treatment is also possible.
Rehabilitation methods
MS is a progressive disease that eventually leads to physical disability. Therefore, the aim of rehabilitation is to minimize the complications of the disease, which include paresis, excessive muscle tension, reduction of the range of joint mobility, balance disorders, ataxia, pain and rapid fatigue, disorderspassing stool and urine, speech disorders resulting from executive dysfunction of the tongue, palate, throat, larynx), dysphagia. An equally important goal of rehabilitation is to influence the patient's psyche and motivate him to fight to maintain fitness. Recommended methods of rehabilitation are:
- functional rehabilitation, i.e. improving or maintaining the mobility of the patient in accordance with his expectations and needs,
- kinesiotherapy, i.e. treatment with movement, conducted by qualified physiotherapists,
- improving neuromuscular priming PNF (proprioreceptive neuromuscular facilitation), which enables the restoration of motor function through the use of receptors scattered throughout the body,
- recreating natural human movements Bobath (neurodevelopmental treatment).
What during a relapse?
Rehabilitation should be limited and non-forcing. Regular breathing exercises should be performed as they help to relax the body and prevent respiratory diseases. When the patient does not get out of bed, it is necessary to frequently (every 2-3 hours) change the position of the body to avoid pressure ulcers. Self-service can also be an exercise, i.e. help with the daily toilet, change of underwear, clothes and self-catering. Passive exercises are helpful, i.e. when the therapist or a trained family member lifts the patient's leg or arm up, or bends it or twists it slightly.
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