MS Rehabilitation

Despite increasing evidence that rehabilitation and physical activity are effective for people with MS (Multiple Sclerosis), often it still isn’t used to fight fatigue in MS patients.

Body movement and fatigue

People with MS used to be advised to rest in order to prevent aggravation of MS symptoms. Recent studies show that body movement and rehabilitation therapy doesn’t harm MS patients. It has even been proven to reduce fatigue.

Different types of exercise have been tested (cardio training, resistance training, rehabilitation therapy, hydrotherapy), with generally positive results in terms of feeling fatigued and with an improvement in quality of life for the MS patient.

Experience shows that it is often difficult for people with MS to start training and to persevere. Access to training areas is often restricted and the inability to use some devices can be frustrating. The recommended intensity and standard duration of the exercises are also often not suitable for patients with MS. Therefore, a tailor-made rehabilitation programme is needed to cover the diverse and individual challenges.

Starting rehabilitation therapy may cause a temporary deterioration in MS symptoms. Reducing fatigue is not immediately noticeable either. This can lead to people giving up on rehabilitation treatment, which is a real shame because by adjusting the intensity and duration of the rehabilitation exercises, the training will be better tolerated. However, because MS fatigue varies from day to day, or even within one day, it can be difficult to maintain daily therapy exercises. Therefore, rehabilitation treatment must be constantly adapted to the capabilities of each individual patient at all times.

Rehabilitation Treatments

In the treatment of MS, a distinction is made between symptomatic treatments and treatments that influence the course of the disease.

Symptomatic treatment

Symptomatic treatments are aimed at controlling the acute symptoms during an attack, or at annoying symptoms that can arise in the course of the disease, such as spasms or urinary incontinence. Medicines are often used for this purpose, but aids can also be useful.

An attack in MS can occur quite suddenly and, depending on the severity of the symptoms, treatment with methylprednisolone may be necessary, to shorten the duration of the attack. However, it does not affect the eventual recovery.

Treatments that affect the course of MS

This treatment aims to reduce the incidence of new MS attacks and to limit and hopefully prevent gradual deterioration in the long term. Unfortunately, it has not yet been possible to cure or stop MS. Because the course of MS varies from patient to patient, the treatment of each patient is specified individually in consultation with the neurologist and the rehabilitation doctor.

Rehabilitation

In the Medifi tReha rehabilitation centre, we offer both inpatient (hospitalised and 24-hour medical care) and outpatient rehabilitation.

Three phases of rehabilitation:

The purpose of rehabilitation is to help people with MS to regain their independence. Such a period consists of three phases:

1. Observation
During the observation period, your possibilities, limitations and daily functioning will be established. At the end of this period, under the supervision of the rehabilitation physician, the practitioners will work with you to draw up a rehabilitation treatment plan in which achievable goals are set. Your rehabilitation physician will discuss this with you.

2. Treatment
During treatment we work towards accomplishing your treatment goals. Every 2 weeks the medical team review the progress of the treatment and the treatment plan is adjusted if necessary. Your rehabilitation doctor will discuss this with you afterwards. The duration of the treatment varies from person to person. In addition to individual treatments, group treatments can also take place in the exercise room or in our swimming pool during the rehabilitation process.

3. Completion
In the final phase, you will prepare for the period after your time with us at Medifit Reha. The number of treatments is then reduced. If necessary, the treatment is transferred to practitioners outside the rehabilitation department. Finally, you will an conversation and evaluation with your rehabilitation doctor.

Practitioners and therapists

During the rehabilitation period you will work with different practitioners from our multidisciplinary team. Under the guidance of the rehabilitation physician, our team of professionals will work together and complement each other with their specialities.

Various disciplines will be involved in your rehabilitation process, such as: a rehabilitation physician, neurologist, physiotherapist, occupational therapist, speech therapist, cognitive therapist, psychologist, neuropsychologist, chiropodist, orthopaedist and many others. Rehabilitation professionals work in a team and they consult with other specialists, such as the neurologist and your general practitioner, in order to guarantee continuity of care.

Where can rehabilitation help you with fatigue?

Teaching people with MS to deal with fatigue means providing lifestyle advice and non-pharmacological aid, often in the form of rehabilitation by a physiotherapist or occupational therapist.

They may, for example:

Design a rehabilitation exercise programme based on the person’s abilities and goals.

After the exercise sessions, the patient can continue practicing at home or independently in a exercise room. Periodically it is checked whether the recommendations are still correct and whether the exercises are still opportune.

Learning to save energy.
Since people with MS often have a limited amount of energy, the aim is to make the best possible use of that energy during the day. We intent to have the activities that are most important and demanding ready before the energy runs out. Some of our suggestions may even help to increase the total amount of energy available.

Identify the tools needed to reduce the energy required in daily operations.
For example, a splint, a walking stick, or a walker can reduce the energy required to walk. It can also help to compensate for the loss of manual strength or mobility.

Recommend changes
These may be changes in your home, in the car, or in the workplace. They are designed to make it easier to carry out day-to-day activities.

Conclusion

Fatigue is one of the most common symptoms of MS and can have a disabling effect. Although the cause of MS is not yet fully understood, there is scientific evidence that exercise and changes in lifestyle are beneficial. Rehabilitation can help and ensure that people with MS have a better understanding and happier daily lives.

Rehabilitation possibilities

At the Medifit Reha rehabilitation centre, we have many years of experience in the rehabilitation for people with MS, for both inpatient as outpatient care. Our rehabilitation programme is multidisciplinary and tailored to the individual situation and needs of each person with MS.