How Physiotherapy can help you fight the symptoms of Multiple Sclerosis

How Physiotherapy can help you fight the symptoms of Multiple Sclerosis

Multiple Sclerosis (MS) is an autoimmune inflammatory disease affecting the insulating covers (myelin sheath) of the nerve cells of the brain and the spinal cord affecting normal function. Though the disease was first documented in 1868 by Jean-Martin Charcot, no definite cause or treatment plan has been discovered. Signs and symptoms for MS range from being physical, mental and also in some cases psychiatric. Since a definite cure for the disease is not available, the best way to treat it is by attempting to restore affected body functions with physiotherapy and related treatment techniques.

Physical Therapy for Evaluation
MS displays a varied range of signs and symptoms, so detecting the disease is very difficult. The evaluation process requires specific assessment of various bodily functions to determine the disease occurrence.



  • Posture and Balance assessment

Balance impairment is one of the most common symptoms of MS which increases the risk of injuries due to falls. Posture, both when seated and standing, must be evaluated to observe the level of assistance needed. If possible, a physical therapist might also document posture and balance during normal functions like movement to and from a bed, toilet seat, car and floor. Effect of balance impairment on Disequilibrium tests (eye-head test, caloric reflex, rotation tests and head-thrust test) may be performed for balance assessment.

  • Ambulation / Gait assessment

Individuals are assessed for vestibular system dysfunction (sensory system that is responsible for maintaining balance), fatigue, spasticity and muscle weakness which might lead to physical injuries through falls and other deleterious activities. Tests also might be conducted to prescribe the best suited assistive equipment to compensate for absent normal function. Ambulation or gait assessments might be carried on regularly by your physiotherapist to note progress as well as the changing need of assistive equipment.

  • Range of Motion and Motor function

Physiotherapists conduct passive and active range of motion assessment to determine problem areas to work on. Hip flexors, abductors, hamstrings and heel chords are inspected for tightness, while restricted overhead reach is examined through tightness in the chest muscles (pectoralis major and minor) and trunk muscles (latissimus dorsi).

Physical Therapy exercises
After thorough evaluation, your therapist will create a customised treatment plan with a strong emphasis on exercises for recovery and rehabilitation.

  • Range of Motion exercises

For spasticity in the affected leg muscles, physiotherapists might recommend stretches that maintain the length of your muscles, while preserving flexibility. Exercises for chest muscles and tiny rib muscles might also be incorporated in the treatment plan depending on the type of normal function disability.

  • Balance and Coordination exercises

To fight balance problems caused by dysfunction of vestibular system, the Epley manoeuvre or Brandt-Daroff exercises might be incorporated in the treatment plan. Exercises of various intensities are recommended, depending on the level of movement impairment and the type of muscle affected.

  •  Aerobic Exercises

Aerobic exercises are performed under observation of your physiotherapist. In the beginning of your treatment plan, intensity and pace of these exercises is kept low to avoid injuries from falls. More exercises would be incorporated depending on an individual’s progress. It is also very important to have your therapist gauge your fatigue levels. The effects of fatigue when suffering from multiple sclerosis are much harder to overcome sometimes lasting for 3 or 4 days after becoming fatigued from your exercises or even your daily activities. Your therapist can help you to moderate these levels as you work with them to find the optimal exercise program.