Multiple sclerosis (MS) damages the myelin in the central nervous system (CNS) and the nerve fibers themselves, which interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body. This disruption of nerve signals produces the main symptoms of multiple sclerosis (MS), which can vary depending on where the damage has occurred. Physical activity targeting the improvement and maintenance of function and the prevention of unnecessary secondary conditions is an important component of comprehensive, quality health care for people with multiple sclerosis (MS), at all stages of the disease.
CORE Program Focus Areas
Functional Electrical Stimulation
According to a study conducted by the Neurology Department at John Hopkins University School of Medicine, a functional electrical stimulation (FES) program for the treatment of multiple sclerosis (MS) is beneficial in multiple ways. Improvements in walking speed, walking distance and strength in stimulated muscles are achievable with regular functional electrical stimulation (FES) use. In addition, the proven medical benefits of functional electrical stimulation (FES) such as the prevention of muscle atrophy, increased circulation, maintained or increased joint range of motion, reduced spasticity, reduced incidence of urinary and bladder infections, osteoporosis prevention and cardiovascular health are all reasons to participate in a functional electrical stimulation (FES) program. The study also hinted a functional electrical stimulation program may have the ability to reduce inflammation and encourage neuronal repair, delaying the progression of the disease. More studies are planned to determine the feasibility of this theory.
Range of Motion/Flexibility Training
Range of motion exercises are essential to and the most basic element of an activity based program for clients with multiple sclerosis (MS). Exercises to stretch the muscles and move the joints through their full range of motion are helpful in maximizing the functionality and well-being of those diagnosed with multiple sclerosis (MS), while also preventing contractures and spasticity.
“In order to improve your balance, you may have to lose your balance!” – The National MS Society
CORE addresses balance problems in two ways. First, balance is improved by managing symptoms such as spasticity and fatigue through range of motion/flexibility training and functional electrical stimulation (FES). Secondly, CORE challenges the client’s balance with the use of what is known as vestibular exercises. This involves exercises and techniques designed to induce brief periods of loss of balance in an effort to teach the body how to adapt.
Many clients diagnosed with multiple sclerosis (MS) will allow their center of gravity to drop, which results in a negative change in posture. Naturally, this will result in a limited range of mobility and be a secondary cause of the pain and fatigue associated with multiple sclerosis (MS). This also affects balance and could lead to a fall. At CORE, correct postural alignment techniques will be utilized to allow for an optimal workout and to increase function and safety while decreasing pain.
One particular gait training method utilized at CORE for multiple sclerosis (MS) clients is body weight supported treadmill training (BWSTT). Body weight supported treadmill training (BWSTT) consists of walking on a treadmill with body weight support and manual assistance, if needed. Body weight supported treadmill training (BWSTT) systems, like the LiteGait, provide a secure environment that provides stability to the trunk and reduces the amount of weight bearing in the legs. The reduction in weight bearing and stabilization of the trunk makes it possible to train weak muscles in a natural walking pattern. The body weight supported treadmill training (BWSTT) allows for repetitive task specific sensory stimulation, which is favorable for motor learning. Studies have shown walking speed and endurance can be improved using a body weight supported treadmill training (BWSTT) system in persons with multiple sclerosis (MS).
Load Bearing Exercise
People with multiple sclerosis (MS) are at particular risk for osteoporosis due to a combination of factors, such as a lack in certain nutrients and side effects from medications used to treat symptom flare-ups. Lowered levels of vitamin D and calcium make it harder for the body to retain bone density or strength. At CORE, we utilize a variety of load bearing exercises to strengthen bones in an effort to prevent the onset of osteoporosis.
Whole Body Vibration Training
Whole body vibration (WBV) training is implemented through the use of a vibrating platform on which static poses are held or dynamic exercises can be performed. The Multiple Sclerosis Trust published a study indicating whole body vibration (WBV) training combined with traditional exercise provided more benefit than exercise alone in reducing muscle spasms and related pain. There was also a trend towards a greater increase in muscle strength with the addition of whole body vibration (WBV).
From CORE’s perspective, one of the biggest benefits of whole body vibration (WBV) is it allows for those with multiple sclerosis (MS) to exercise in ways that help provide the benefits of working out without creating large amounts of fatigue.
Muscular Strength and Endurance Training
Studies indicate strength training for those with multiple sclerosis (MS), specifically resistance training, improves muscular strength and the ability to perform common daily activities, which also improves the overall quality of life. In addition to practical benefits, there is evidence that strength training may delay the degenerative effects of multiple sclerosis (MS).
Until recently, there was concern that persons with multiple sclerosis (MS) might be unable to tolerate aerobic exercise regimens, primarily because of their susceptibility to heat-related worsening of symptoms and also fatigue. There is now evidence-based data showing that not only can persons with multiple sclerosis (MS) tolerate standard aerobic exercise, but that they can benefit from it. Reported benefits include better cardiovascular fitness, improved strength, better bladder and bowel function, less fatigue and depression, a more positive attitude and an increased quality of life.
A Pilot Study of Functional Electrical Stimulation Cycling in Progressive Multiple SclerosisResistance Training Improves Muscle Strength and Functional Capacity in Multiple SclerosisA Study Into the Effects of Whole Body Vibration in MS