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This article reviews treatments for the rehabilitation of multiple sclerosis patients.

Multiple sclerosis (MS) is an autoimmune inflammatory disorder that causes demyelination in the central nervous system. Progression of the disease leads to chronic neurological deficits. Professional rehabilitation therapy during the disease course can reduce disability and improve the functional status of MS patients. A study in the journal Frontiers in Immunology reviewed the established methods and new technologies for the rehabilitation treatment of MS.

Rehabilitation Mechanism

Rehabilitation treatment reduces peripheral inflammatory cytokines, improves neuroplasticity, and slows neurodegeneration and disease progression.

Current Status of MS Rehabilitation Therapy

The first step in rehabilitation therapy is to evaluate the patient’s dysfunction level with the help of various scales to evaluate function, such as the Extended Disability Status Scale, Multiple Sclerosis Quality of Life Inventory, and others. Then targeted and personalized therapy is provided through psychological rehabilitation, exercise therapy, sensory training, speech and swallowing training, cystorectal function training, etc. Comprehensive rehabilitation for at least 12 months is needed for continued beneficial effects, so family rehabilitation training after discharge is recommended under the guidance of professional rehabilitation therapists.

New Technologies in MS Rehabilitation

The emergence of new rehabilitation technologies for MS has made rehabilitation therapy an indispensable tool in managing MS.

  •         Transcranial Magnetic Stimulation 

Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation technology that directly regulates the central nervous system. It causes axon depolarization and improves the excitability of the corticospinal system, enhances synaptic transmission, and stimulates neuroplasticity. Repetitive TMS is well-tolerated and has almost no side effects. Large-scale studies are needed to refine the optimal stimulation parameters for TMS therapy.

  •         Virtual Reality Technology
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Virtual reality (VR) technology immerses the patient in a virtual environment and stimulates the brain through multi-sensory, task-oriented feedback. It can activate mirror neurons, leading to cortical and subcortical brain changes, and stimulate synaptic reorganization and remyelination in the brain’s motor regions. Studies show improved balance, movement, and cognitive function in MS patients in response to VR therapy. There is a need for more international research to standardize the therapy.

  •         Robot-Assisted Gait Training 

Robot-Assisted Gait Training (RAGT) is accomplished through an exoskeleton and body weight support system, which generate repetitive gait movements, increasing in time and intensity. This therapy improves gait characteristics, balance, and lower limb stability.

  •         Telerehabilitation

Telerehabilitation uses internet technology to establish communication between patients and physicians across time and space. It is a convenient, cost-effective, and fast method for continuing rehabilitation post-discharge.

  •         Transcranial Direct Current Stimulation

This non-invasive technique involves the transmission of weak direct current to the cerebral cortical surface for nerve regulation. Its mechanism in alleviating MS symptoms is unclear; however, studies on MS patients show improvement in pain, fatigue, and quality of life with this therapy.

Source

Duan, H., Jing, Y., Li, Y., Lian, Y., Li, J., & Li, Z. (2023). Rehabilitation treatment of multiple sclerosis. Frontiers in Immunology, 14. https://doi.org/10.3389/fimmu.2023.1168821