Multiple sclerosis (MS) is a chronic neurological disease in which the immune system attacks myelin, the protective sheath that covers nerve fibers. This damage disrupts or distorts the signals the brain sends to the rest of the body, affecting movement, balance, coordination, and muscle strength.
Although MS is a disease that evolves over time, neurological rehabilitation plays a fundamental role not only in regaining mobility after a flare-up, but also in maintaining it, slowing functional decline, and improving long-term quality of life.
How does multiple sclerosis affect mobility?
- Spasticity: muscle stiffness and spasms that hinder voluntary movement
- Muscle weakness: especially in the legs, which affects gait
- Cerebellar ataxia: lack of coordination and balance that increases the risk of falls
- Neurological fatigue: disproportionate exhaustion that limits physical activity
- Intention tremor: involuntary movement that hinders fine motor skills
- Sensory disturbances: numbness or loss of sensation in extremities
Principles of mobility rehabilitation in MS
Neuroplasticity and multiple sclerosis
Although MS damages nerve pathways, the brain retains a capacity for adaptation and reorganization that can be stimulated through exercise and rehabilitation. Regular therapeutic physical activity promotes the creation of new neural connections and can partially compensate for the damage caused by the disease.
Exercise does not worsen MS
There is a myth that exercise is harmful in multiple sclerosis. Scientific evidence demonstrates the exact opposite: properly adapted aerobic exercise and strength training are safe and beneficial for most MS patients. The only aspect to monitor is the increase in body temperature (Uhthoff phenomenon), which can temporarily worsen symptoms.
Rehabilitation techniques to improve mobility
Neurological physiotherapy — Bobath Concept
The Bobath Concept is one of the most widely used approaches in neurorehabilitation for multiple sclerosis (MS). It focuses on retraining normal movement, postural control, and balance, reducing spasticity and improving coordination. At Rehabot, we apply this method as the foundation of our MS mobility treatment.
Gait and balance training
Gait retraining is a priority goal for many patients with MS. Techniques include treadmill training with partial weight support, use of balance platforms, and gait exercises on different surfaces and under varying conditions.
Treatment of spasticity
Spasticity is one of the symptoms that most limits mobility. The physical therapist uses stretching techniques, thermotherapy, positioning, and neuromuscular facilitation to reduce it and improve motor function.
Occupational therapy
When upper limb mobility is affected, occupational therapy works on the recovery of hand and arm function, adapting daily life tasks to maintain the maximum possible autonomy.
Technical aids to improve mobility
Depending on the severity of the condition, some people with MS may benefit from assistive devices to improve their mobility and safety: ankle-foot orthoses (AFOs) to improve gait, canes, walkers, or wheelchairs when walking becomes impossible. Physical therapists and occupational therapists provide guidance on when and how to use each assistive device without creating unnecessary dependence.