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Novel Physiotherapy Approach for Multiple Sclerosis

Elzbieta Miller and Marta Niwald

Multiple sclerosis is a chronic, complex disease with a variety of clinical symptoms and affects mainly young and middle-aged people. Research and therapies are focused on the early phase of MS, especially relapsing-remitting MS (RRMS). There is the need for novel therapeutic strategies especially oriented towards neuroprotection in the chronic phase. Accumulating data outlines the beneficial role of physiotherapy in individuals with MS. A physiotherapy program improves muscle strength, balance, walking capacity and decreases spasticity, while also enhancing mood, cognitive function and reducing fatigue. Currently, neurorehabilitation programs are among themost popular therapies for reducing the disabilities and social disadvantages of MS patients. Rehabilitation strategies in MS should be based on the promotion of motor learning-related neuroplasticity improving functional outcomes. Therefore, the interdisciplinary team is essential for maximizing the patient's ability to function. In this review current treatment, symptoms and clinical phenotypes, the role of rehabilitation, main measures that are recommended to estimate disability, impairment and handicap of MS are presented. Additionally, aerobic training as a factor enhances cognitive function by upregulation of neurotrophins, such as brain-derived neurotrophic factor(BDNF) was showed. First of all this review focuses on the novel methods used in multiple sclerosis patients including telerehabilitation and cryostimulation.