THERAPY-Magazin
Therapy recommendations for improving mobility in MS patients
Jakob Tiebel
Business Owner, N+ Digital Health Agency
In its S2e guideline “Bewegungstherapie zur Verbesserung der Mobilität von Patienten mit Multipler Sklerose”, the German Society for Neurological Rehabilitation (DGNR) makes therapy recommendations for improving the mobility of patients with multiple sclerosis. Which treatments are beneficial?
The primary type of therapy for improving the mobility of multiple sclerosis patients is therapeutically guided gait training. This is usually done on the floor but can also be done on a treadmill. In any case, it must be designed so that the patients are challenged by the training in terms of endurance and strength. It is advisable to perform targeted testing of the foot flexor, hip flexor, calf muscles and quadriceps in advance, as these muscles often show a strength deficit in MS patients. Depending on the findings, weaknesses in these areas should be trained by strengthening the relevant muscles separately.
Balance training is recommended as a complementary therapeutic tool for a safe gait and particularly for preventing falls. It is not a replacement for gait training, however. In the study, pilates, yoga, tai chi and hippotherapy showed similar effects to traditional balance training, which is why these forms of therapy can be used for variety, particularly in patients with milder symptoms.
Motor imagery and vibration training are not recommended. These showed no effect on the mobility of the patients in the study.
The fundamental goal of treating MS patients is to increase their own activity. This should also be based on the WHO physical activity recommendations for people with health conditions (150 minutes of moderate exercise or 75 minutes of high-intensity exercise per week). Of course, the individual physical conditions of the patients must be taken into account. In this context, the study also examined the influence of telerehabilitation, for example in the form of virtual reality or telecommunication (video tutorial). It was shown that these procedures significantly increased the patients’ activity in everyday life and were thus a worthwhile complement to the therapeutic interventions.
The overview graphic summarises all treatment recommendations.
Balance training is recommended as a complementary therapeutic tool for a safe gait and particularly for preventing falls. It is not a replacement for gait training, however. In the study, pilates, yoga, tai chi and hippotherapy showed similar effects to traditional balance training, which is why these forms of therapy can be used for variety, particularly in patients with milder symptoms.
Motor imagery and vibration training are not recommended. These showed no effect on the mobility of the patients in the study.
The fundamental goal of treating MS patients is to increase their own activity. This should also be based on the WHO physical activity recommendations for people with health conditions (150 minutes of moderate exercise or 75 minutes of high-intensity exercise per week). Of course, the individual physical conditions of the patients must be taken into account. In this context, the study also examined the influence of telerehabilitation, for example in the form of virtual reality or telecommunication (video tutorial). It was shown that these procedures significantly increased the patients’ activity in everyday life and were thus a worthwhile complement to the therapeutic interventions.
The overview graphic summarises all treatment recommendations.
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Jakob Tiebel
Business Owner, N+ Digital Health Agency
Jakob Tiebel studied applied psychology with a focus on health economics. He has clinical expertise from his previous therapeutic work in neurorehabilitation. He conducts research and publishes on the theory-practice transfer in neurorehabilitation and is the owner of Native.Health, an agency for digital health marketing.
References:
- Deutscher Verband für Physiotherapie (ZVK) e. V. (2019). Fokus Forschung: Therapieempfehlungen zur Verbesserung der Mobilität bei Multiple Sklerose, online zugegriffen am 09.03.2020: https://www.physio-deutschland.de/fachkreise/news-bundesweit/einzelansicht/artikel/detail/News/fokus-forschung-therapieempfehlungen-zur-verbesserung-der-mobilitaet-bei-multiple-sklerose.html.
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