Plasmapheresis and other types of therapy for patients with multiple sclerosis: description of procedures. Gymnastics for patients with sclerosis
Multiple sclerosis(in Latin Sclerosis Multiplex), abbreviated SM is a disease involving inflammation of the insulating layers on nerve fibers in various areas brain and spinal cord. The damaged layers can no longer regenerate and are replaced by hard scar tissue. Because it does not have the conduction capabilities of healthy tissue, the transmission of nerve signals is disrupted or completely blocked.
The most common symptoms of SM are disturbances in vision and speech, problems with intentional movement of the arms and legs, and a decreased sense of touch and sensitivity to pain.
(Video: “Multiple sclerosis is a disease with a thousand faces”)
Walking and grasping are difficult, and limb strength is reduced. Functional disorders Bladder and intestinal disorders are also common.
In multiple sclerosis, no doubt effective means protection against failures in coordination and contractures. On the other hand, physical therapy can provide a clear improvement in the patient's movement capabilities, teaching him concentration and some automatic movement. As long as the exercises are repeated consistently and repeatedly, the effects of physical therapy in this area can be surprisingly good.
The goal of rehabilitation is also to stabilize the patient’s condition and delay further development diseases. Practical significance The goal of physiotherapy is to allow the person suffering from multiple sclerosis to move as much as possible and perform the basic functions needed in daily life.
The physiotherapeutic method is movement: both active, carried out independently by the patient, and passive, with which the therapist helps.
The choice of a specific treatment method depends on the type and degree of disability. As a general rule, it should be said that each person suffering from multiple sclerosis requires individual care and precise selection of exercises.
Before starting therapy
In the case of multiple sclerosis, physical therapy should be started very carefully. The patient's load should be slow and gradual. Excessive haste leads to a deterioration in the patient’s condition and even to the loss of certain body functions.
Ideally, before starting an exercise, the physiotherapist should monitor the client's condition and identify goals that can and should be achieved.
The entire treatment plan should be discussed directly with the patient. Thus, he will be interested in cooperation. This is especially important on initial stage physiotherapy, when the exercises are difficult for the patient and involve great effort.
It is advisable to provide analgesics and diastolic medications before physical therapy. This makes it easier for the patient to perform the exercises and thus increases the effectiveness of the therapy. However, medications must be measured carefully to avoid addictive effects. Of course, you need to work directly with your doctor.
Principles
- Active gymnastic exercises should begin with mild symptoms of the disease and be carried out consistently.
- Exercises should be selected individually for the patient's condition.
- The exercise program should be updated depending on the patient's needs.
- The exercises are performed in such a way that diagonal tension and muscle relaxation alternate. Always use both affected muscle groups and healthy parts of the body.
- Always start with the most simple exercises and gradually increase the difficulty level.
- Whenever possible, the patient should exercise on a hard surface (not in bed).
- Patient cooperation is very important from the very beginning of physical therapy.
- Through exercises, the patient should gain some practical skills, such as turning from side to side, sitting on the bed with legs on the floor, walking with assistance or on our own, self-administration food, etc.
Advanced Exercises
As the therapy program progresses, the patient must learn to maintain balance in all major body positions. To do this, you can use various devices and auxiliary devices. The patient should become familiar with how they are used.
Spastic patients
The physical therapist should pay attention to even the smallest type of contracture.
Each contracture in combination with muscle weakness quickly leads to reduced mobility and even complete inability to move independently. During exercise, focus not only on the muscles directly affected by spasticity, but also on those near the affected areas.
To decrease muscle tension and improve blood circulation, you can use compresses from cold water, ice or perform active hydrotherapy. It also turned out to be useful to load the arms and legs with special belts with a lead insert. This helps slow down uncontrolled movements and jerks, and thus has a positive influence to perform basic operations and exercises. The weight of such a belt must be individually adapted to the patient's needs. Weighing down items needed for daily use is also helpful.
Working with spastic patients requires a lot of effort from the physiotherapist. Therefore, if such a possibility exists, it is advisable to carry out the exercises using special equipment. For patients with myasthenia gravis, care should be taken to ensure that the patient is not at risk of pressure ulcers.
The most effective exercises for multiple sclerosis
- The patient lies on his back on a hard surface. The spread legs are bent at the knees so that the entire surface of the feet rests on the ground. The arms are located along the body. The exerciser raises his hips and torso. Shoulders do not leave the ground. Through a short time there is a return to the original position.
- The patient sits on a ball or therapy roll. Therapist, standing nearby with the patient, helping him perform balance exercises. First, the exerciser holds the ball with both hands and rests his feet on the floor. Then he moves on to more difficult exercises and reduces support by raising arms and legs in turn.
- The patient is kneeling (with the body in a horizontal position, leaning on straight arms). He raises his straight arm up, trying to reach as high as possible. The weight of the body is transferred to the hand resting on the ground. The patient returns to the starting position. The hand changes.
- The patient practices walking with the help of a handrail, thanks to which he supports himself with both hands while taking steps.
- The patient lies on his back on a hard surface. Legs are straight, arms lie along the body. The therapist grabs the patient's leg from below with one hand and holds the other on the knee. He then gently lifts the patient's leg toward the chest while bending it at the knee. Returns to original position. After the repeated movement, the leg changes.
Regularly performed breathing exercises prevent the progression of the disease in this direction. In addition, they are preparatory in nature for carrying out other stages of physiotherapy.
Hydrotherapeutic treatment of multiple sclerosis
Movement in the water or even – if possible – swimming is an important part of physical therapy. A patient who constantly suffers from body imbalances and contractures experiences a feeling of greater confidence and control over their body during hydrotherapy because the water slows down sudden and uncontrollable movements. In addition, the patient in water, apparently losing weight, can move with much greater ease than usual and needs less strength to maintain body balance. Therefore, when performing exercises in water, the patient experiences better efficiency of your efforts. Movement in water is a good form of preparation for typical more complex therapeutic exercises.
The water temperature must be adjusted to the individual needs of each practitioner. Most patients prefer colder baths. They feel more efficient and relaxed wearing them. In this case, a temperature of 23-26 degrees Celsius is recommended. Some patients respond to more warm water, but experience shows that at temperatures above 30 degrees Celsius the patient quickly gets tired.
Hippotherapy is a valuable addition to classical methods physiotherapy. However, horses must belong to calm, so-called “cold-blooded” breeds (for example, Hutsul or Icelandic horses). They must also be properly trained. Therapy can only be carried out by specialists, and the patient must be constantly monitored.
Riding a horse is a pleasant experience for the patient. This reduces muscle tension, helps in balancing exercises, builds self-confidence and encourages further work. The participant sits on a horse without using a saddle. Thus, the movement of the animal is transmitted directly to the rider.
It should also be emphasized that contact with horses has a calming and calming effect on most patients.
Exercises for the sense of touch
The patient learns to re-evaluate the sense of touch when dealing with different materials. In doing so, it tries to determine the type of material, surface structure, temperature, size, shape, etc.
Music therapy
Relaxation techniques are recommended in cases of multiple sclerosis. Each period when the disease is in a milder course should be used for rest, relaxation and gathering strength. Relaxation methods also have a regenerative effect on the patient’s psyche, thanks to which he can approach the disease more realistically, assess its condition and current course.
Recent years have brought many changes to modern therapy, including treatment of multiple sclerosis.
A patient with multiple sclerosis, a limited disability, checks his habits, reduces activities that have accompanied him throughout his life, which have worsened his quality of life. The therapist's determination of the loss of function and the goals of rehabilitation provide the opportunity to accurately improve the patient's condition.
Multiple sclerosis (MS) is a chronic demyelinating disease nervous system. Physiotherapy plays a role in multiple sclerosis important role in maintaining and improving physical performance patients. Physiotherapy interventions can help people with MS live more active lives.
Multiple sclerosis causes sensory disturbances varying degrees. Patients may experience numbness, tingling, muscle paralysis, and cramps that quickly fatigue the muscles.
How does physical therapy help with MS?
Frequency and duration treatment sessions physiotherapy depends on the duration and severity of the process
The main goal of physical therapy is to strengthen the muscles, improve coordination and endurance of the patient. Patients with MS begin to feel better after physical therapy own body and more effectively control the limbs. Physiotherapy also eliminates painful sensations, muscle spasms and movement disorders of varying severity.
During therapy, some body functions that were impaired or lost due to MS can be almost completely restored. Several studies have shown that regular physical therapy over a period of several weeks can help:
- restore the ability to walk long distances;
- improve motor skills;
- reduce the manifestations of fatigue in everyday life.
In addition, physical therapy can prevent the development mental disorders that arise during the course of the disease. However, does this also apply to patients with MS on last stage, has not yet been studied.
Physiotherapy for MS has both short-term and long term goals:
- In the short term it is necessary to reduce pain syndrome and muscle tension.
- In the long term, quality of life should be improved through exercise to develop a sense of body balance and coordination.
What physiotherapy methods are used to treat patients?
Vojta therapy is indicated for MS patients
Physiotherapists use different methods to help people with MS achieve best quality life. Basic methods of physiotherapy:
- Bobath method;
- Vojta therapy;
- bioresonance therapy;
- proprioceptive neuromuscular propagation;
- manual therapy.
A physical therapist must undergo certified training to be able to use the above methods in clinical practice. Which method is used in adjunctive therapy for multiple sclerosis depends on the patient's symptoms.
Bobath therapy is a physiotherapeutic technique in which a patient with MS is retrained to perform stereotypic movements. The method is used if, for example, a limb is completely or partially paralyzed.
In Bobath therapy, the therapist moves the affected part of the body, imitating natural movement. The brain must learn to feel again certain part body and reproduce correct sequence movements.
Vojta therapy also aims to relearn correct posture and movements. In this technique, the physical therapist specifically presses on certain points in the body to trigger innate reflexes. Vojta therapy is especially useful in cases of coordination problems.
Manual therapy can be used to relieve pain
At manual therapy A physiotherapist uses hands to relieve pain that may be caused by MS. To do this, he carefully moves joints and stretches certain parts of the body, such as fingers. As a result, the muscles relax and stretch, and cramps disappear.
Proprioceptive neuromuscular propagation therapy (PNP therapy) is a method that allows you to restore functional connections between nervous and muscular system. PNP therapy helps improve patients' coordination and relieve muscle tension.
How effective is physical therapy?
There is ample evidence that exercise used as part of a rehabilitation program can increase activity and improve health in people with MS.
In addition, there is growing evidence that physiotherapists, as part of specialist neurorehabilitation services, play a key role in improving the quality of life of patients. Physiotherapeutic procedures help patients get rid of spasms, pain and motor disorders.
Results from randomized controlled clinical trials have shown that physical therapy for MS can improve muscle strength, cardiovascular system, increase your aerobic threshold and level of physical activity.
A number of physiotherapeutic methods are effectively used for PC
Where is physiotherapy performed?
Physical therapy can be performed in home, outpatient and inpatient conditions. In some cases, the stage of the disease determines the location of physical therapy.
Inpatient physical therapy
Upon admission to a medical facility, a patient with MS will undergo mandatory physiotherapeutic treatment. Physical therapy is often provided at an MS treatment center or long-term care facility.
Most people who need inpatient physical therapy have suffered some kind of injury due to MS. People with progressive MS can also live in a care center. These patients may require physical therapy as part of their treatment.
Outpatient physical therapy
Ambulatory treatment performed in the office of a doctor, physical therapist, or therapeutic center. People scheduled for outpatient physical therapy come to the location designated by the doctor.
Outpatient physical therapy can be good choice for people recovering from a relapse or learning to cope physical changes with MS.
Physiotherapy at home
The patient can hire a personal physical therapist and perform physical therapy at home. People at all stages of MS can benefit from the services of a physical therapist at home.
Physical therapy can be especially helpful for people who have recently been diagnosed with MS. Home care is also recommended for patients with late stage RS.
One of the most important points If you have a diagnosis of MS, it is important to understand not only what you can and should do, but also what you cannot do if you have multiple sclerosis. Obviously, we will not talk about general bad habits, like alcohol and smoking. We will proceed from existing experience and advice from doctors.
For multiple sclerosis
- overdo
- don't rest
- lack of sleep
- strength exercises with weights
- exercise until you get tired
- activities that lead to exhaustion
- strict diet
- starvation
- excessive stress at work
- hard physical labor
- oddly enough, to get sick
- bath, sauna, steam room, hot baths
- some medications
Sometimes, it happens that we lose track of time, stay up late finishing a project, or party all night long, or simply have a lot of things to do around the house. The situation, as they say, is like a double-edged sword. And I want and inject. Excessive efforts on the body when it already wants to rest will not lead to anything good in patients with multiple sclerosis. Any overdoing, as a rule, leads to new exacerbations. The whole trick of this disease lies in the slow reaction. A relapse does not occur instantly, but rest assured that by provoking the disease, it will sooner or later respond to you with an exacerbation. Therefore, the first point of our contraindications will be:
- You can’t rape your body! And, if you start to get even a little tired, drop everything and go to rest in horizontal position! Rest is now your friend and in this friendship you are not in charge.
Nutrition
We all know that nutrition is important, but for us it is rather not just important, but necessary. Due to the first point of contraindications for multiple sclerosis, we may forget to eat and skip meals. Allowing yourself to do this once, everything will happen again. Then don't let it. Malnutrition or overeating is a kind of violence against the body. Any disturbances in the stable functioning of the body can lead to exacerbations. Develop habits. Well, you somehow taught yourself to go to the toilet and brush your teeth in the morning. We draw a conclusion and write the second paragraph:
- Don't skip meals, but don't overeat either. We remember about harmony. Don’t abuse your body once again, now it is ten times more special.
Hypothermia and heat
In general, temperature is a separate topic for a post. We exclude everything that can essentially provoke exacerbations or worsen existing ones. So heat is the exception. Even to an ordinary person It can get worse in direct sunlight, let alone for a person with MS. You will have to say no to your favorite bathhouse, just like the sauna. High temperatures, doctors believe, reduce the conduction of signals in the nerves. The following point of contraindications:
- Categorically exclude sudden change climate, bathhouse, sauna, and always remember that heat, is the enemy of multiple sclerosis.
Exhaustion
Any type of fatigue, including those leading to exhaustion of the body, can have a bad effect on the patient. The word exhaustion should be understood strict diet, fasting, excessive exercise, marathons, etc. Anything that makes you sweat is not positive unless we're talking about about multiple sclerosis. So:
- Avoid any activities that lead to exhaustion of the body.
Disease
Oddly enough, being sick means provoking an exacerbation. A weakened immune system is good chance for myelin attack. MS does not sleep, even when the body needs to treat a cold. - Try not to get sick. Preventive measures can help. To avoid catching the virus during an epidemic, do not leave home again without a bandage.
Medicines
Exacerbation may be caused by taking medicinal substance indomethacin, which is used to treat inflammatory and degenerative diseases musculoskeletal system. From the group of non-steroidal anti-inflammatory drugs, aspirin and paracetamol are considered safe.
Interferon gamma drugs are contraindicated, as they provoke and aggravate both the disease and its symptoms. It is recommended to carefully consider the prescribed immunomodulators, including interferon inducers. Any drugs based on Echinacea are contraindicated. Get into the habit of consulting your doctor before starting to take any medication, especially despite the warnings on the packaging.
Excessive exercise
Intensive sports and other similar activities directly associated with severe debilitating physical activity, should be excluded. Work in gym, pumping up muscles, is a direct synonym for the word exhaustion. Required in urgently exclude this type of activity from your schedule.
After exacerbations during the rehabilitation period, therapeutic exercises, work with musculoskeletal musculoskeletal system, body balance exercises, physiotherapy. Massage will help you quickly return to a working, active state. These measures contribute less to the manifestation of functional disorders.
attention
If you change your health or take medications, be sure to consult your doctor. A trusting relationship with a doctor in case of multiple sclerosis is important step to maintaining normal life!
Multiple sclerosis - chronic autoimmune disease CNS, in which the myelin sheath is affected nerve fibers brain and spinal cord. That is, the formation of so-called plaques occurs - foci where myelin is destroyed white matter. The size of the plaques can range from a few millimeters to several centimeters; with the progression of the disease - larger fused formations.The cause of the disease has not yet been precisely established, but the generally accepted opinion among experts is that multiple sclerosis is the result of the interaction of a number of unfavorable external and internal factors. The first include bacterial and viral infections, ecology, geography (place of residence), solar radiation, toxic substances, poor nutrition, injuries, chronic stress. As for the genetic predisposition to the disease, it is most likely associated with the presence in a person of genes that determine immunoregulatory disorders.
As a rule, multiple sclerosis is diagnosed in young and middle-aged people (from 15 to 40 years old) against the background of the appearance of characteristic symptoms in patients neurological symptoms: progressive disorder motor activity, muscle spasms and weakness, eye pain and visual disturbances (blurredness, optic neuritis, double vision, tingling), dizziness with nausea and vomiting, slurred speech, urinary incontinence, constipation, severe fatigue and mood changes, confusion, memory loss, unilateral facial paralysis, partial or complete paralysis of the body.
If symptoms of multiple sclerosis are suspected, the patient must attend a consultation with a neurologist, where a comprehensive comprehensive examination will be prescribed, the main methods of which in this case are:
- MRI examination
- immunological blood test
- clinical blood test
Treatment of multiple sclerosis involves the whole complex methods, primarily medicinal, aimed at eliminating exacerbations, alleviating the symptoms of the disease, as well as changing its course and slowing down its development, protecting the myelin sheaths nerve cells from attacks immune system and the brain and spinal cord from getting into them immune cells. Also complex therapy includes therapeutic exercises, biomechanotherapy, hydrokinesitherapy, physiotherapeutic procedures.
Physiotherapy in the complex treatment of multiple sclerosis
Physiotherapeutic techniques have long proven themselves to be highly effective in complex treatment. neurological disorders along with drug therapy. In particular, with multiple sclerosis, physiotherapy can achieve good results, acting both in the plane of preventive means and being used for acute stage course of the disease, and maintaining a comfortable level and decent quality of life during remission.
Thus, the attending physician, after making a diagnosis and selecting a course drug therapy, refers the patient to a consultation with a physiotherapist, where, taking into account the characteristics of the medical history, the presence of contraindications, current state the patient, the stage and nature of the disease, and a physical treatment program is determined. As a rule, it includes (individually or collectively):
- ultraphonophoresis of hydrocortisone - exposure of the body to ultrasound in combination with a corresponding medicinal substance applied to the skin;
- magnetotherapy - exposure to static magnetic current in order to influence the speed of biophysical and biochemical processes in organism;
- amplipulse therapy - healing method based on electrical stimulation of problem areas to relieve pain;
- mineral, as well as coniferous, sulfide, chloride baths to reduce muscle spasticity;
- plasmapheresis is a procedure in which plasma is separated from blood cells, thereby cleansing the latter from toxic and metabolic components, antibodies, and significantly alleviating the patient’s condition during an attack;
- decimeter wave irradiation to the liver area with a power of up to 20 mW. in order to increase physical activity and reduce chronic fatigue syndrome.
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Multiple sclerosis is chronic disease, which affects the head and spinal cord. The development of this pathology is associated with the destruction of the myelin sheath of nerve fibers as a result immune disorders, which leads to the formation of plaques from connective tissue in the affected area. These structures interfere with the normal passage nerve impulse, as a result of which the brain ceases to fully control the body.
Treatment of sclerosis requires integrated approach and application of highly effective methods. Neurologists at the Yusupov Hospital provide treatment of this disease and rehabilitation of patients aimed at restoring lost functions.
Treatment of sclerosis
Women aged 20 to 30 years are most susceptible to developing the disease. The development of multiple sclerosis is associated with a complex of external and internal factors. External factors the risk of developing multiple sclerosis are:
- regular stressful situations;
- poor nutrition;
- smoking and abuse alcoholic drinks;
- viral infections;
- vitamin D deficiency.
On early stages development of multiple sclerosis, the patient may not show signs indicating destruction of the conductive fibers. Magnetic resonance imaging is performed to make a diagnosis and determine how to treat sclerosis. By auxiliary methods diagnostics for this disease are: detection in cerebrospinal fluid immunoglobulins, as well as monitoring the functioning of the immune system.
Specialists at the Yusupov Hospital, when treating patients with signs of multiple sclerosis and complaints of deterioration in coordination of movements, decreased muscle strength, impairment of intelligence and a number of other functions, carry out comprehensive diagnostics using high-precision equipment.
The data obtained during the examination of the patient allows neurologists at the Yusupov Hospital to develop individual program therapy. Treatment for multiple sclerosis includes three elements:
- treatment of the disease in the acute stage using corticosteroid drugs that reduce inflammation. These drugs help reduce the rate at which immune cells travel to the brain. Medicines used by specialists at the Yusupov Hospital are registered in the Russian Federation; they help eliminate symptoms;
- pathogenetic therapy using specific agents, the effect of which is to correct impaired functions, normalize the functioning of the immune system and metabolism. When selecting drugs, take into account possible contraindications and others individual characteristics sick;
- Symptomatic therapy, based on usage highly effective drugs and rehabilitation aimed at eliminating the consequences of the pathological process.
Treatment of patients with multiple sclerosis is the common work of doctors of various specializations at the Yusupov Hospital. In multiple sclerosis, it is impossible to completely stop pathological process, however adequate therapy and regular examinations can slow down the progression of the disease.
An effective remedy for sclerosis
Treatment of sclerosis is carried out at the Yusupov Hospital using various drugs having different actions. Yes, some medicines reduce muscle hypertonicity, eliminate increased activity bladder, help improve intelligence and coordination of movements.
Achievements modern medicine, used by neurologists at the Yusupov Hospital, allow you to correct various disorders with sclerosis. When treating patients with relapsing-remitting multiple sclerosis, the drug Lemtrada is used, which is supplied directly from the manufacturer in France. Efficiency this tool proven by numerous foreign studies.
Treatment of sclerosis with folk remedies
Experienced neurologists say that no two patients with multiple sclerosis can have the same set of symptoms of the disease, so individual therapy is necessary in each case. However, many people who do not know how to treat sclerosis trust the advice on forums of other patients and self-medicate.
Folk remedies for the treatment of multiple sclerosis are various tinctures based walnut, elderberries, hare cabbage juice. In addition, patients often take baths with spruce or pine shoots. Usage folk remedies for the treatment of multiple sclerosis does not eliminate the manifestations of the disease, correct emerging disorders and stop the progression of the disease.
Folk remedies can complement basic therapy in the absence of contraindications. However, neurologists at the Yusupov Hospital use only scientifically proven methods in the treatment of multiple sclerosis.
You can get a consultation with a highly qualified neurologist when visiting a modern medical institution. To register at convenient time contact the coordinator doctor by phone at the Yusupov Hospital.
Bibliography
- ICD-10 ( International classification diseases)
- Yusupov Hospital
- Gusev E.I., Demina T.L. Multiple sclerosis // Consilium Medicum: 2000. - No. 2.
- Jeremy Taylor. Health according to Darwin: Why we get sick and how it is related to evolution = Jeremy Taylor “Body by Darwin: How Evolution Shapes Our Health and Transforms Medicine.” - M.: Alpina Publisher, 2016. - 333 p.
- A.N. Boyko, O.O. Favorova // Molecular. biology. 1995. - T.29, No. 4. -P.727-749.
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