Multiple sclerosis affects people with reduced energy due to:
· sensory-emotional overload;
· high mental stress;
· chronic lack of sleep;
· intense loads in sports;
· burnout syndrome;
· chronic stress;
· lack of physical activity;
· spinal cord and brain blood supply deficiency as a result of early osteochondrosis.
Analysis of the disease etiology and pathogenesis in terms of healthy energy distribution allow you to formulate a strategic vision of the situation. The mechanisms for the MS development - the destruction of the body neurodynamic connections through demyelination. It happens in condition of a total energy shortage, when the main task is to provide energy to vital systems and the body compensatory disconnects from participation in energy distribution is all energy-consuming and “secondary”.
In case of multiple sclerosis, the body perceives large energy-intensive skeletal muscles of the lower extremities, pelvic girdle, shoulder girdle and upper limbs.
In case of disconnecting, the body implements self-preservation mechanisms at the tissue level.
The approach to reconstructive a multiple sclerosis treatment is based on biomechanical techniques, carried out in energy-saving and energy-subsidized mode. The author's training simulators are used to work in the afferentation mode neurodynamic exercise with the aim of:
· optimization of hemo and cerebrospinal fluid dynamics of spinal cord;
· early osteochondrosis signs elimination, as degenerative-dystrophic process in the tissues
· of the musculoskeletal system;
· The work optimization of individual organs and life support systems;
· elimination of muscular-articular imbalance;
· elimination of the causes and consequences of burnout syndrome.
The rehabilitation plan and forecast is making for the near and distant future.
Urgent rehabilitation begins immediately after the onset of acute manifestations of the disease, in the first days of multiple sclerosis exacerbation. The task is to complement a medical treatment, to stimulate natural regenerative processes and promote maximum prevention of persistent disorders.
Long-term rehabilitation program aimed to the long-term patient improvement, preservation and restoration of the organs and systems functions, reducing the frequency the occurrence of exacerbations and the intensity of their manifestation.
For each symptom-complex, biomechanical elimination techniques have been developed that are included in physical rehabilitation programs for multiple sclerosis:
· decrease in spastic state of muscles;
· the pelvic organs function normalization - urination, intestinal motility, pancreatic function, stomach;
· reduction of sensory disturbances;
· increase in motor activity;
· reduction of chronic fatigue syndrome;
· restoration of impaired motor functions;
· minimize complications in the form of thinning of bones and osteoporosis;
· normalization of weight impaired as a result of physical inactivity and corticosteroids;
· improving daily activity;
· neutralization side effects of medical treatment with immune-suppressors, hormonal, anti-inflammatory preparations, symptomatic medicine therapy.
The basic rehabilitation principles (MS) are: timeliness, regularity, unity of preventive and rehabilitation measures, an interdisciplinary approach, individuality. Staging is determined by a work combination in the center and at home, is discussed and planned with a personal physician and patient.
Approaches to physical and biomechanical rehabilitation with multiple sclerosis patients:
1. Development of a personalized rehabilitation program, taking into account the form, severity, stage and prevailing symptoms of multiple sclerosis.
2. The use of afferent neurodynamic stimulation methods: the patient’s energy resource is not wasted, as in arbitrary exercises; the energy resource of the instructor is used, acting as an external drive equipped with the necessary simulator designs and devices.
3. Engineering designs of simulators ensure the safety of recovery and allow the instructor to turn on the muscular-articular cascades in the sequence necessary for rehabilitation, in accordance with a personal program to dose physical activity in strength, amplitude, frequency.
4. Physical activity is carried out in a sparing mode from 20 to 40% of the patients physical abilities.
5. All loads change from descending, when the body performs according to the central nervous system command, to ascending in an eccentric mode - the body responds to the instructor.
6. The program includes passive exercises to restore muscle-joint balance, resistance exercises, and endurance development and movements coordination.
7. Fractional workouts are used with exercises for resistance and endurance in an energy-accumulating eccentric mode. This minimizes the likelihood of overload, fatigue, and muscle weakness, while maintaining daily activity.
8. One of the key components of rehabilitation programs for patients with multiple sclerosis is improving walking function. Due to the fact that with multiple sclerosis large energy inputs are required for movement, loads with the inclusion of basic long multi-link muscle chains help optimize anti-gravity tensor systems, which makes walking more energy-saving. Keeping the walking skill, without leading to fatigue, they allow conducting training systematically and daily, supporting physical activity and expanding it.
9. The alternation of training “work-rest” in the ratio of 1/10, fractional distribution of loads in the first half of the day, dividing physical activity into short sessions, allows you to get a cumulative effect, avoiding the deterioration of the patient general condition.
10. The energy-consuming concentric loads elimination. The rehabilitation process is based on the energy- saving eccentric mode of physical activity, when the force is set externally by the instructor, and the patient responds to the impact of feasible resistance.
11. Specific spinal loads, chest, trunk, aimed at maintaining the body’s energy and the energy distribution, are carried out in a pendulum cascade-wave biomechanical mode, supporting all functions of coordination, gait and balance.
12. The eccentric loads that form the basis of the rehabilitation program exclude the possibility of overheating. The patient can perform a set of exercises without worsening the general condition and sensory disturbances.
13. Safety is ensured by the participation of a personal instructor who manages the training, setting the amplitude, effort and frequency of repetitions, eliminating the possibility of overload.
14. The effectiveness and uniqueness of physical exercise is provided by the training equipment, designed for the patients rehabilitation of the multiple sclerosis.
Stages of the rehabilitation process:
1. Development of a personal treatment and rehabilitation strategy;
2. Forming of a personalized rehabilitation program;
3. Program staff training;
4. Well-equipped rehabilitation room with copyrighted training constructions;
5. Author’s control over the quality of rehabilitation classes;
6. Pathophysiological analysis of the effectiveness by all the proposed physiotherapeutic, rehabilitation and training methods and techniques;
7. Expert opinion in choosing a strategy;
8. Second opinion.