I know I have probably whined too much on this site about the state of MS drug development and the usefullness of existing drugs. I'll probably continue to complain about all that. In the meantime, however, I have been seeing a few interesting articles about physical rehabilitation in MS patients. I became interested about exercise when I saw on TV a few months ago a show about a man in his 60s with Parkinson's disease who ran marathons. He was on Parkinson's meds, and occasionally had problems with "freezing up", but he kept plugging, and his general physical condition was actually very good, much better than most men his age. His doctors were of the opinion that his exercise actually had some neuroprotective components to it and reduced the severity of his Parkinson's disease. It was very inspirational to see him. I don't post this thread to suggest we all just go and become aspiring marathoners - (MS aside, my knees protest too much) but what has caught my eye in MS publications that physical therapy has helped people with MS improve/regain functions.
As a personal testimonial for rehab, I believe a short round of physical therapy greatly helped me with a specific problem - after a knee injury, and months favoring the knee, I lost a lot of physical strength in my legs and was developing some actual balance problems. I suspect MS-related processes contributed to that. I was getting almost tottery. I asked for a physical therapy referral and with about 2-3 sessions and some simple exercises really helped my legs, balance and stabilize the bad knee.
Here's a recent article:
Ann Readapt Med Phys. 2006 May;49(4):143-9. Epub 2006 Feb 28. Related Articles, Links
[Strength, postural and gait changes following rehabilitation in multiple sclerosis: a preliminary study]
[Article in French]
Cantalloube S, Monteil I, Lamotte D, Mailhan L, Thoumie P.
Service de Reeducation Neurologique, Hopital Leopold-Bellan, 21, rue Vercingetorix, 75014 Paris, France.
OBJECTIVE: To evaluate the impact of rehabilitation on balance, gait and strength in inpatients with multiple sclerosis (MS). METHODS: Twenty-one in patients with MS benefited from a program of rehabilitation with evaluation before and after rehabilitation. Balance was assessed by stabilometry, walking speed with use of a locometer device and maximal peak torque of knee extensor and flexor with use of an isokinetic dynamometer at 60 degrees /s speed. The functional independence measure (FIM) was also applied before and after rehabilitation. RESULTS: After rehabilitation, patients showed significant improvement in balance with opened and closed eyes, velocity gait, strength of the lower quadriceps and the higher hamstrings and FIM values. Absolute values of gait speed and strength parameters were related as were improvement in velocity speed and the higher hamstrings. CONCLUSION: The results are encouraging and confirm the interest and tolerance of a program of rehabilitation among patients with MS.
PMID: 16545886 [PubMed - indexed for MEDLINE]
Here's an abstract of a recent review article:
Expert Rev Neurother. 2006 Mar;6(3):347-55. Related Articles, Links
Physical exercise in multiple sclerosis: supportive care or a putative disease-modifying treatment.
Heesen C, Romberg A, Gold S, Schulz KH.
Department of Neurology, University Medical Center, Martinistrasse 52, 20246 Hamburg, Eppendorf, Germany. firstname.lastname@example.org
Multiple sclerosis (MS) is a neuroinflammatory and neurodegenerative disease affecting young adults and leading to considerable disability. For many years, patients have been advised to avoid physical activity. Today, however, an increasing number of studies have shown beneficial effects of exercise training in MS. It has been reported that such programs not only improve fitness parameters but can also enhance quality of life and beneficially affect some suggestive disability measures. Pilot studies even indicate a neuroprotective potential. This review summarizes the findings of the major clinical trials on exercise in MS. Possible biological effect mediators, such as neurotrophic factors or anti-inflammatory cytokines, will be discussed. Exercise management guidelines will be proposed and possible further research strategies are presented.
PMID: 16533139 [PubMed - indexed for MEDLINE]
I'll post some more on this thread later - there are articles that deal with specific problems like foot drop, head stability, etc. Maybe people will find something helpful in these abstracts.