Thursday, 12 April 2012

Multiple Sclerosis

What is it?
Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system, that is, the brain and spinal cord. All nerves are surrounded by a myelin sheath – a protective layer surrounding the nerves. This myelin sheath assists in the conduction of neural signals from the brain to the muscles, innervating the muscles and thereby creating muscular contractions. With MS, demyelination of these sheaths occurs, resulting in the neural conduction along the nerves being adversely affected. Speed of conduction is reduced and the result is a reduction in smooth, rapid and coordinated movement. The effects can range from little or no disability to severe disability.


Various types of MS exist
The National Multiple Sclerosis Society identifies 4 types of MS: relapsing remitting, secondary progressive, primary progressive and progressive relapsing. The most common form is relapsing remitting MS (RRMS). In this case, one has relapses, where symptoms are present, and then periods of remittance, where symptoms subside or disappear altogether. The more relapses a person has, the more severe the symptoms become. Stress, both physical and emotional, is the main contributing factor causing a relapse.

Causes
MS occurs as a result of the myelin sheath surrounding the nerves being damaged. This can be due to inflammation, when the body’s own immune cells attack the nervous system (autoimmune disease). The reason for this is unknown, but is thought to be due to a virus or genetic defect.

Who is at risk?
MS is more common in women. It is generally diagnosed between the ages of 20 and 40, but can occur at any age.

Symptoms
MS affects numerous body systems, including the eyes, bowel and bladder, sexual function, speech and swallowing and, most noticeably, the muscular system. In this blog, I will discuss the muscular system only. According to ACSM, the physical symptoms include the following:
  • Spasticity
  • Incoordination
  • Impaired balance
  • Fatigue
  • Muscle weakness, paresis (partial paralysis) and paralysis
  • Sensory loss and numbness
  • Cardiovascular problems
  • Tremors
  • Heat sensitivity

The role of exercise in managing MS
The progression or prognosis of MS is not affected by exercise. However, a person with MS will still experience the short-term benefits of partaking in a regular exercise programme, such as improved cardiovascular fitness, increased strength and flexibility, and improved functional ability. People with MS often lose function in their legs, resulting in them being unable to walk. It is important to strengthen and stretch the leg muscles in order to prolong function. One should also focus on balance and stability exercises to reduce the risk of falling.

Important things to remember
People with MS do not have the same ability to regulate their body temperature as those without MS, so it is important to keep the room temperature in which you are exercising cool.
If muscles are overworked or overstretched, this can cause an acute inflammatory response, which may exacerbate symptoms. So, take it easy! Rather use lighter weights and do more repetitions to improve endurance and muscle tone.

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