1. Four Hot Topics:
Balance, Fatigue
Spasticity and
Headache
Monique M. Canonico DO
Assistant Professor, John A. Burns School of Medicine
2014 Lecture Series- NMSS
3. Balance
Balance issues may affect over 50% of
people living with ms
Study was done in 2008 by Cameron et al
Tested by SSEPs
Subjects with MS demonstrate differences
in the delay in postural response latencies
between their two legs
4.
5. 4 Strengthening and Balance Exercises to Try at Home
1 Heel raises/toe raises: Stand up on tippy-toes and hold for
5 seconds,
lower, and then rock back on your heels by lifting your
toes up,
and hold for 5 seconds. Do this 10 to 15 times.
2 Leg balance: Stand on one leg and hold for up to 30 seconds.
Add in challenges like raising your arms to the side or
holding overhead to make the exercise more difficult.
Repeat this on a variety of surfaces, such as tile, carpet,
and standing on a foam cushion to strengthen the
connections between physical movement and mental
association.
3 Foot exercises: Toes and feet play an important role in
balancing. Use your toes to pick up small objects, like marbles
or tissues, off the floor. This strengthens the calf and
intrinsic muscles of the feet. Do this 5 to 10 times on each side.
4 Balance: Walking in a heel-to-toe pattern forward and
backward. Take 5 to 15 steps in each direction.
As you train, be aware of your MS symptoms. Challenge
yourself but do so in a safe environment
7. There is no evidence
whatsoever that exercise in
persons with MS can lead to an
exacerbation. As a matter of fact,
in studies of persons
with MS who
exercise aggressively there
was no higher
incidence of exacerbation
than non-exercisers.
8. Tai Chi
Tai Chi is a wonderful approach to
balance training. The research has been
very, very clear that persons with MS,
when they use Tai Chi as balance training
that it does improve their balance.
Editor's Notes
Balance problems and falls are common in people with multiple sclerosis (MS) but their cause and nature are not well understood. It is known that MS affects many areas of the central nervous system that can impact postural responses to maintain balance, including the cerebellum and the spinal cord. One study found that 54% of a group of 50 patients with MS reported 1 or more falls in the previous 2 months and 32% reported 2 or more falls in the previous 2 months (Cataneo et al. 2002
SSEPs were evoked by stimulation of the posterior tibial nerve in the leg and the median nerve in the arm. Peripheral conduction time was assessed by measuring the conduction time from the periphery to the low thoracic (T12) spinal cord (N20 potential) for the posterior tibial nerve, and to Erb’s Point (N9 potential) for the median nerve. Total central conduction time was obtained by recording at the cortex (P37) and recording at cervical spine (P27 for the posterior tibial nerve and P13 for the median nerve) was used to divide total afferent conduction time (ACT) into spinal and supraspinal components
People with MS who exercise too aggressively can have excessive fatigue and this is called a pseudoexacerbation - a false exacerbation. What happens is the person has a transient worsening of symptoms, but they get better within one or two days and sometimes in a matter of hours. It’s not an exacerbation, but it’s simply that they’ve exercised too hard. They improve.
T'ai chi ch'uan or Taijiquan, often shortened to t'ai chi, taiji or tai chi in English usage, is an internal Chinese martial art practised for both its defense training and its health benefits. It is also typically practised for a variety of other personal reasons: its hard and soft martial art technique, demonstration competitions, and longevity
