Multiple Sclerosis

What is It?

Multiple Sclerosis (MS) is a chronic, usually progressive, disease that primarily affects young adults. Approximately 400,000 people in the United States and 2.5 million people worldwide have been diagnosed with MS. Its effects vary widely. Although there is no known cure for the disease, it can be successfully controlled with medical management and rehabilitation.  This disorder affecting a portion of the nerves known as the myelin sheath, essentially the “insulation” around your nerves that allows them to conduct signals normally.  For most people, a phase of demyelination, the loss of the sheath, is usually followed by periods of relative stability.  Rehab for patients with MS occurs in two different stages: one during a period of demyelination, and one during remission.

Treatment

During demyelination, therapy should focus on energy conservation.  Because of the loss of myelin, nerves will not be able to recover from firing very quickly, and muscle will not be able to activate repetitively of forcefully.  Using a variety of techniques and tools, therapists can help keep life more independent and efficient during this phase!

In a remission phase, a certain amount of regrowth of myelin is common!  However, because of the effects the demyelination has on muscle firing, most patients will need significant retraining on balance, strength, endurance, and motor control to return closer to how they felt beforehand. Newer research has shown that it can be safe during a remission phase to work harder than we ever thought possible before, meaning patients can now expect to achieve higher and higher outcomes during remission to have a less progressive loss of strength and skill over the lifespan!