MOTOR NEUROREHABILITATION IN PATIENTS WITH MULTIPLE SCLEROSIS

Abstract

Multiple sclerosis (MS) is a chronic, autoimmune, demyelinating disease of the nervous system with a probable genetic predisposition that predominantly affects young people. The pathogenesis of the disease is thought to involve immune-mediated inflammatory demyelination and axonal damage. Demyelinating diseases, which include multiple sclerosis, are pathological conditions in which the myelin sheath that surrounds nerve fibers in the brain and spinal cord or peripheral nerves is damaged. The most common symptoms are problems with the autonomic, visual, motor and sensory nerves. Symptoms of MS vary widely in type and severity and may include generalized fatigue, tingling, numbness, painful sensations, slurred speech, and blurred or double vision. Some people experience muscle weakness, poor balance, poor coordination, muscle tightness or spasticity, tremors or paralysis, which may be temporary or permanent. Treatment consists in slowing down the progress of the disease and managing the symptoms. Motor neurorehabilitation significantly reduces the functional deficit in patients with multiple sclerosis and increases autonomy in daily functioning. The aim of this research is to trace the effect of motor neurorehabilitation in patients with a secondarily progressive form of multiple sclerosis with a longer course of development. Material and methods: 8 patients with secondarily progressive form of MS (8 women, mean age 47.3±4.7 years) are included in our research. The means of motor neurorehabilitation are used: correct positioning in bed and in a sitting position, passive-active exercises, analytical exercises for upper and lower limbs, respiratory exercises, balance and coordination exercises from a sitting and standing position, and massage treatments. For the analysis of the effect of the means of motor neurorehabilitation, transfer tests are used (transition from occipital lying to left/right lateral lying, from occipital lying to standing), Berg balance scale test and Five test Times Sit -To- Stand (FTSST), which is useful for evaluating transfer possibilities. Results: The research shows that the means of motor neurorehabilitation affect the speed of reactions and muscle strength of the patients, the strength of the lower limbs, the balance, the coordination and the sequence of movements between the thorax and the lower limbs are improved. After the application of these means of motor neurorehabilitation in patients with secondarily progressive form of MS, the highest tendency for improvement was revealed at the 1st month and the level of significance p<0.001. Conclusion: The longer performance of the exercises as part of the complete neurorehabilitation in patients with secondarily progressive form of MS has a positive effect on physical health, which improves the balance, speed of reactions and muscle strength of the patients, strength of the lower limbs, coordination and sequence of the movements between the thorax and the lower limbs.