Why does a patient with MS need maintenance sessions?
Multiple sclerosis is a chronic disease with no cure at present. That doesn’t mean there’s nothing that can be done: it means that the therapeutic work never truly ends.
Once the patient has reached their maximum functional potential through intensive rehabilitation, maintenance sessions are what ensure that this level is maintained over time.
Without maintenance, MS patients tend to gradually lose the functionality they have gained. The nervous system, without regular stimulation, regresses. Spasticity increases, balance worsens, and gait deteriorates. Maintenance sessions are, in this sense, as important as the initial intensive rehabilitation.
| What happens if maintenance is discontinued? • Progressive increase in spasticity and muscle rigidity • Impaired balance and increased risk of falls • Worsening gait and loss of independence • Increased fatigue in daily activities • Loss of gains achieved during the intensive rehabilitation phase |
What do the maintenance sessions consist of?
Maintenance sessions are not the same as intensive rehabilitation. They are generally shorter (45-60 minutes) and their frequency is tailored to each patient, usually between 1 and 3 times per week. Their goal is not to regain new functions, but to preserve those already acquired and prevent deterioration.
Typical contents of a maintenance session
- Static and dynamic balance exercises to prevent falls
- Muscle stretches to control spasticity
- Gait training in different conditions
- Adapted lower limb strength exercises
- Coordination and fine motor skills work
- Relaxation techniques and fatigue management
- Review and update of assistive technologies if necessary
How often are sessions recommended?
There is no single answer: the ideal frequency depends on the type of MS (relapsing-remitting, secondary progressive, primary progressive), the degree of functional impairment, the stage of the disease, and the individual goals of the patient.
In general terms, most patients with stable MS benefit from 1-2 weekly maintenance sessions supervised by a physiotherapist, supplemented by a home exercise program that the therapist designs and updates periodically.
Home exercise program: the essential complement
Physiotherapy sessions are more effective when combined with a home exercise program. The therapist designs a personalized routine, tailored to the patient’s level of fatigue and functionality, which can be performed independently at home between sessions.
- Daily stretches to maintain flexibility
- Balance and proprioception exercises
- Progressive walking according to tolerance
- Strengthening exercises adapted to the stage of the disease
- Postural hygiene techniques
Maintenance and outbreaks: what to do when there is a worsening?
MS relapses can cause a temporary worsening of symptoms. During the acute phase of a relapse, rehabilitation is adapted by reducing its intensity and focusing on postural maintenance and preventing complications. Once the relapse has passed, a more intensive period of rehabilitation may be necessary to regain the previous level of function before returning to maintenance.
At Rehabot we continuously monitor the progress of each patient and adjust the maintenance program in response to any changes in their clinical condition.
Why should maintenance be done by a specialist?
Maintaining multiple sclerosis is not simply a matter of generic exercise. It requires the supervision of a physiotherapist specializing in neurology who understands the disease, can detect changes in the patient’s condition, and adjusts the program accordingly. Improperly dosed exercise can lead to excessive fatigue or even trigger symptoms of Uhthoff’s phenomenon.