Multiple Sclerosis (MS)

Plain-language definition

Autoimmune disease of the central nervous system evolving in relapses. Rehabilitation adapted to fatigue and capabilities.

Signs and points requiring attention

• Variable motor disorders depending on plaque location and relapses: weakness in one or more limbs, movement coordination disorders (ataxia), walking difficulties. Intensity fluctuates over time with relapse-remissions.
• Disabling chronic fatigue affecting up to 80% of MS patients: 'primary' fatigue related to the disease itself and 'secondary' fatigue due to sleep disorders, spasticity or medications. This fatigue considerably impacts daily life.
• Spasticity and muscle weakness: increased muscle tone causing stiffness and spasms, associated with decreased strength. These symptoms limit mobility and can cause pain if not treated with regular physiotherapy.
• Balance and coordination disorders (cerebellar ataxia): walking instability, difficulty coordinating movements, dizziness. These disorders increase fall risk and require specific proprioceptive work.

• Signs of a new relapse: sudden visual disturbances (double vision, optic neuritis), new limb weakness, persistent numbness. Contact your neurologist quickly for evaluation and treatment.
• Rapid and unusual worsening of existing symptoms beyond normal fluctuations. A relapse is defined by new or worsened symptoms lasting more than 24 hours in the absence of fever.
• Appearance of new urinary or bowel symptoms: urinary urgency, retention, incontinence. These symptoms require specialized care to prevent complications.

Assessment and care

• Rehabilitation adapted to MS-specific fatigue: split exercises, regular breaks, avoidance of body overheating (Uhthoff phenomenon). Session scheduling at times of least fatigue according to patient's rhythm.
• Spasticity management through prolonged gentle stretching, joint mobilizations, cryotherapy and inhibition postures. Prevention of contractures and maintenance of joint range to preserve functionality.
• Balance and proprioception work on varied surfaces: wobble boards, eyes-closed exercises, dual task. Improvement of automatic postural reactions to secure daily walking.
• Progressive and adapted muscle strengthening: exercises against moderate resistance, avoiding excessive heating. Targeting weak muscles while respecting limits imposed by fatigue.

This information does not replace diagnosis or medical consultation.