Neurorehabilitation in Multiple Sclerosis – Resilience in Practice

Abstract

In recent years, enormous strides have been made in increasing the range and efficacy of disease-modifying drugs available for the treatment of multiple sclerosis (MS) in its early and remitting stages, and more continue to emerge. Another equally important concept of successful treatment of MS is neurorehabilitation, which must be pursued alongside these medications. Key factors that contribute to the impact of neurorehabilitation include resilience and neuroplasticity. In the former, components such as nutrition, self-belief and physical activity provide a stronger response to the disease and improved responses to treatment. Neuroplasticity is the capacity of the brain to establish new neuronal networks after lesion damage has occurred and distant brain regions assume control of lost functions. In MS, it is vital that each patient is treated by a coordinated multidisciplinary team. This enables all aspects of the disease including problems with mobility, gait, bladder/bowel disturbances, fatigue and depression to be effectively treated. It is also important that the treating team adopts current best practice and provides internationally agreed standards of care. A further vital aspect of MS management is patient engagement, in which individuals are fully involved and are encouraged to strive and put effort into meeting treatment goals. In this approach, healthcare providers become motivators and patients need less intervention and consume fewer resources. Numerous interventions that promote neurorehabilitation are available, though evidence to support their use is limited by a lack of data from large randomised controlled trials. Combining interventions that promote neurorehabilitation with newer, more effective treatments creates a promising potential to substantially improve the outlook for patients at all stages of MS.

The Arrival of the Metaverse in Neurorehabilitation: Fact, Fake or Vision?

“…This goal could be achieved through a multidisciplinary strategy where the clinical team participated in the patient’s needs and therapists’ assessment of problems (mobility, self-care ADL, communication, daily occupations, and social interactions). Several studies demonstrated that this kind of inpatient or outpatient rehabilitation programs may reduce disability and bladder dysfunction, and improve participation in neurological patients [ 59 ].…”

Neurorehabilitation in Multiple Sclerosis—A Review of Present Approaches and Future Considerations

“…Furthermore, research shows that the newly formed network connections in the brains of MS patients have a higher complexity level than the previous architecture of the healthy brain, unlike other conditions, such as stroke, where brain tissue restoration follows its original network patterns [ 47 , 48 , 49 , 50 , 51 , 52 ]. In addition, the neuroplasticity of patients with MS could decline after two years of an initial increase, thus leading to a progression of the disease and disability [ 53 , 54 ].…”