Multiple Sclerosis

It is important that people diagnosed with Multiple Sclerosis are assessed by a physiotherapist early on in order to identify hidden effects on balance, posture and movement that may not be initially obvious to them.

Efficient movement and postural adjustments are achieved through a constant interplay of activity throughout the body to ensure that a persons centre of gravity is moving appropriately within any particular base of support and when moving from one base of support to another. i.e. when moving from sitting to standing.

Multiple Sclerosis is a condition of the central nervous system that interferes with this efficiency of interplay and therefore results in disturbances in balance and postural adjustments.

The body will adapt and use compensatory strategies if muscle weakness is present or balance is affected and, although these can appear to alleviate the problem in the short term, the compensatory strategy can result in the avoidance of use of a particular muscle activity or balance mechanism. Muscles and activity over used become fixed and established and weaker muscles can become weaker due to lack of opportunity to interplay, even though they may have potential to participate. It is for this reason that people with longstanding problems can gain improvements from physiotherapy at a later stage.

Physiotherapy is essential to help a person with Multiple Sclerosis develop an insight into the very specific and individual way their condition has affected them, how they can assist in ensuring that their muscles remain active as far as possible within the constraints of their condition and that an appropriate balance of compensatory activity is developed and controlled throughout the often fluctuating nature of their condition.

Developing a persons insight into appropriate balance and movement helps them to identify changes in their presentation and therefore to seek timely intervention/advise. It enables them some control of their situation and an awareness of what to do to try to regain activity that has been lost as they recover from an exacerbation.

It is essential that this input and development of awareness re postural adjustment, functional activity and balance is ongoing throughout changes/fluctuations in a persons presentation.