Outcome of short‐term physiotherapy intervention program on early stage of multiple sclerosis ‐ A case report

Abstract

INTRODUCTIONMultiple sclerosis is a chronic autoimmune progressive disease of demyelination of central nervous system with subsequent axonal damage. The symptoms are due to central nervous system lesions resulting from loss of oligodendrocytes, which myelinates CNS leading to tingling and numbness of limbs and reactive gliosis with no cure for the disease. But CNS diseased effects are often controlled through rehabilitation.OBJECTIVE OF THE STUDYThe aim of this study is to observe the importance of early physiotherapy rehabilitation along with immunosuppressants to suppress and reduce the symptoms and slows down the disease process beginning from the initial day of hospitalization to six weeks which causes progression in the patient reducing the incapacity and improves functional measures and quality of life in multiple sclerosis patients. Muscle weakness, and spasticity, balance and coordination can be improved through stretching and strengthening exercises.METHODPatient strictly followed intervention for a period of six weeks under the supervision of Physiotherapist. Intervention includes strengthening, aerobic conditioning, flexibility exercises, coordination exercise, balance exercises, gait training using assistive devices, sensory, functional, bowel and bladder control training. Interventions were gradually progressed up to the patient every week according to their symptoms. Patient was assessed in 1st and 7th week using the outcome measures namely Functional independence measure (FIM) and Short Form survey‐12 (SF‐12) assessing the impact of health on patient’s everyday quality of life.RESULTSAfter the 7th week re‐assessment, it has been shown there is a difference in the value of outcome measures. FIM level has improved from 3‐moderate assistance with helper to 6‐modified independence without helper. SF‐12 physical score showed marked improvement from 48.020307 to 56.57706 while SF‐12 mental score change showed very minor change.CONCLUSIONMultiple sclerosis disease impairment is primarily a consequence of disease progress, but it can be aggravated by reduced physical activity leading to muscle weakness, decreased ROM, spasticity. Exercise and training have been shown to improve the above said deteriorations in multiple sclerosis patients and certainly can be alleviated.Score through FIM and Health survey scale are tabulated as follows Outcome measure Preintervention Postintervention FIM, Functional Independent Measure (in scales) 3‐‐ Moderate Assistance(>= 50%): Helper‐Modified Dependance 6‐‐ Modified, Independence (Device): No Helper SF‐12, Quality of life measure PCS‐12 (Physical Score): 48.020307 MCS‐12 (Mental Score): 59.04606 PCS‐12 (Physical Score): 56.57706 MCS‐12 (Mental Score): 60.75781