Physiotherapy approach for persons with multiple sclerosis

Abstract

Multipla skleroza jedna je od kroničnih autoimunih bolesti središnjeg živčanog sustava, koja je karakterizirana propadanjem mijelinske ovojnice na živčanoj stanici. Propadanje mijelinske ovojnice može dovesti do prestanka pravilnog prijenosa impulsa između živčanih stanica. Smatra se da je multipla skleroza idiopatska bolest, odnosno da je uzrok bolesti nepoznat, ali se pretpostavlja da se može prenositi genetski ili ako je osoba preboljela neku od upalnih bolesti središnjeg živčanog sustava. Takva bolest je dva puta češća u žena i kod većine osoba javlja se između dvadesete i pedesete godine života. Multipla skleroza očituje se kroz dvije faze. Prva faza je faza egzacerbacije, što se odnosi na period pogoršavanja simptoma i opće stanje bolesnika je veoma loše. U toj fazi simptomi počinju biti intenzivniji. Druga faza je faza remisije kada se simptomi smanjuju ili mogu potpuno nestati. Pojava simptoma ovisi o tome koliko je oštećena mijelinska ovojnica u središnjem živčanom sustavu, a najčešći simptomi koji se pojavljuju su trnci na jednoj strani tijela, umor, poremećaji vida, problemi s koordinacijom, smetnje mokrenja i emocionalni problemi. Obzirom da multipla skleroza nije izlječiva bolest može se usporiti napredovanje same bolesti i simptoma, pa kod liječenja simptoma od velike pomoći su lijekovi i fizioterapijski postupci koji mogu smanjiti bol, ublažiti malaksavost i umor. Kod liječenja osoba koje boluju od multiple skleroze važan je fizioterapeut, jer on mora napraviti pravilan plan i program vježbi koji je individualan za svakog pojedinca. Sama edukacija obitelji o bolesti multiple skleroze i kako se nositi sa tom bolešću kada je ista u fazi egzacerbacije pridonosi velikoj važnosti. Prognoza multiple skleroze je neizvjesna, što znači da kod nekih osoba simptomi mogu biti blagi, dok kod drugih mogu dovesti do značajnije onesposobljenosti, no smatra se da pravilan način života može produžiti fazu remisije i kvaliteta života može se itekako poboljšati.Multiple sclerosis is one of the chronic autoimmune diseases of the central nervous system, characterized by the degeneration of the myelin sheath on nerve cells. The breakdown of the myelin sheath can lead to the failure of proper impulse transmission between nerve cells. Multiple sclerosis is considered an idiopathic disease, meaning its exact cause is unknown, but it is believed that it may be genetically transmitted or triggered if a person has previously suffered from an inflammatory disease of the central nervous system. This condition is twice as common in women and usually occurs between the ages of twenty and fifty.Multiple sclerosis manifests through two phases. The first phase is the exacerbation phase, which refers to a period of worsening symptoms, during which the patient's overall condition is very poor. In this phase, symptoms become more intense. The second phase is the remission phase, when symptoms lessen or may completely disappear. The onset of symptoms depends on the extent of damage to the myelin sheath in the central nervous system. The most common symptoms include tingling on one side of the body, fatigue, visual disturbances, coordination problems, urinary issues, and emotional difficulties. Since multiple sclerosis is not a curable disease, its progression and symptoms can be slowed down. Medications and physiotherapy procedures are very helpful in symptom management, as they can reduce pain, relieve fatigue and exhaustion. In the treatment of individuals with multiple sclerosis, the role of the physiotherapist is essential, as they must create a proper and individualized exercise plan for each patient. Educating the family about multiple sclerosis and how to cope during the exacerbation phase also plays a significant role. The prognosis of multiple sclerosis is uncertain, meaning that for some individuals the symptoms may be mild, while for others they can lead to significant disability. However, it is believed that a proper lifestyle can prolong the remission phase and significantly improve quality of life