Multiple sclerosis is associated with incomplete or incomplete transmission of information to and from the central nervous system. While the exact cause for the disease is not known, much is known about the effect of immune system function, which may be the etiology of the disease. The most common symptom of the disease is fatigue and movement disorders.
There is no drug that cures the disease, but there are treatments available that can modify the progression of the disease. Many of the symptoms of MS can be successfully controlled and treated.
In the past, patients were advised to refrain from any form of exercise on the grounds that symptoms might be exacerbated by an increase in body temperature. Prohibiting a person from participating in any physical activity negatively affects the cardiovascular system, fitness, strength, bone mass and mobility. Today we believe that properly guided exercise can have an improvement in the functions of people with MS.
With the onset of symptoms, there is progressive weakening, fatigue and consequently difficulty at the functional level. Respiratory capacity is closely related to functional ability. Improving cardiovascular health at any level can increase aerobic capacity in many individuals in this population. The combination of guided exercise with physiotherapy intervention provides a statistically significant positive effect on the physical impact of MS and improvement in fatigue symptoms (Garrett, M. Et al, 2012). Research by Klefbeck and Nedjad in 2003 found an increase in respiratory muscle strength due to exercise after a 10 week programme. Importantly, the effects of the exercises remained even one month after the end of the programme.
Supervised and progressively increasing intensity muscle strengthening programmes can bring about changes in the quality of life of people with MS (Giacobbi et al, 2012). In this study the programme lasted 4 months and all participants reported improvements in gait, muscle strength and endurance. They also reported an increase in performance in the tasks of daily living.
One of the most important factors in performing motor skills well is attention, which is related to the interaction of the environment (Mohsen, S. et al 2013). One aspect of attention is the allocation of movements in space to different task demands. In order to plan and select a response to a stimulus, information must be transferred through neurons and processed.
The ability of the brain to change and adapt to demands is called brain plasticity. The neurons most involved in a learning skill, for example, are modified based on the information they receive.
In training these people with neuronal damage, special attention is paid to practice activities. The complexity of these activities promotes the formation of neural synapses. External and internal stimuli (e.g. cues) help the brain to better adapt to an activity such as walking (Mohsen, S. et al., 2013). The more difficult an activity (requirement) is, the easier and faster it is assimilated.
Training for short and long term brain plasticity can improve impaired functionality and disordered neuron connectivity (Tomassini, V. et al, 2011).
Each individual is a different organism, with different habits and lifestyles. The symptoms of the disease manifest in different form and rate. Therefore, it is important that the physiotherapy programme is well linked to the needs, expectations and perspectives of each individual person individually and adapted to their level of physical condition. Exercise programmes should be appropriately designed and readily modifiable in a safe environment without severe temperature changes. The degree of difficulty should be such that excessive fatigue and consequent disruption of information transmission through the neurons is avoided. In other words, we are talking about an individualised physiotherapy programme, with the necessary systematic active participation in the activity programmes and good trusting cooperation with the trainer.
Functional activities promote neuromuscular coordination, training the whole body to adapt to the requirements at hand. They improve balance and teach the individual to perform skills, promoting independence and improving quality of life.
