Multiple Sclerosis (MS) is an inflammatory disease of the brain and spinal cord, that involves an immune-mediated process in which the body's immune system (particularly T cells) abnormally turns on against the central nervous system. The exact trigger or target that the immune system is trying to attack, remains unknown and there currently is no cure. It is thought that environmental factors can predispose a person who is genetically susceptible to develop MS.
In MS, the immune system preferentially attacks the fatty sheath around nerves called myelin, as well as the nerve fibres themselves. The damage leaves scar tissue called sclerosis, and because of this variable damage that can occur at various parts of the brain and spinal cord, a mixture of symptoms are experienced.
Common symptoms include temperature-mediated fatigue, tremors, visual disturbances, sensory changes and difficulties with balance or coordination. Reduced voluntary coordination in movement is called ataxia. Others may also exhibit increased tone and spasticity.
There are 4 types of MS:
Relapse-Remitting - This type is characterised by clearly defined "attacks" that result in a sudden reduction in neurological function called relapses. This is followed by partial or complete recovery of symptoms called remission periods. Most people diagnosed with MS are in this category.
Secondary-Progressive - This type usually follows on after a Relapse-Remitting course. Neurological function begins to take on a more predictable and progressive course without any periods of remission.
Primary-Progressive - This type is characterised by a gradual worsening of neurological function from the start, and may have periods of mild improvement or greater than expected worsening, without distinct periods of remission.
Progressive-Relapsing - The rarest of the four types, this type presents with worsening of neurological function from the start, but punctuated by distinct relapses on a background of gradual decline in function without remission.
Neurological physiotherapists are physiotherapists with additional training and expertise in treating problems related to the brain, spinal cord, inner ear and nerves. Neurological physiotherapists apply their neuroscience knowledge to assess the physical aspects that are affected by MS, so as to individualise a treatment strategy and approach that would enable the person to change their movement behaviour.
With specific attention given to the person’s thinking abilities and fatigue, therapy involve lifestyle recommendations and include an array of interventions such as hydrotherapy, home exercises and gym programs to maximise the individual’s capacity to maintain their physical abilities for as long as possible.