Curezone Physiotherapy, Mississauga collaborates with a team of providers providing treatments in various Musculoskeletal and Neurological conditions including Multiple Sclerosis and Guillain -Barre Syndrome.

Multiple Sclerosis

    Multiple Sclerosis [MS] is an autoimmune disease that affects the central nervous system and can affect all ages but typically resides in individuals falling between 20-40.  Unfortunately, there is currently no cure for MS, however, there are medications that an individual can take that will help manage the symptoms associated with the disease and help increase recovery time from MS attacks.

Symptoms of MS

• Numbness or weak feeling in 1 or more limbs in one side of the body, Lhermitte sign (electric shock sensation occurring as a result or some neck movement)
• Lack of coordination
• Tremor
• Unsteady gait
• Vision problems such as: full/partial vision loss in one eye
• Double vision
• blurry vision
• Fatigue
• Dizziness
• Tingling in parts of body
• Balance, Coordination, & Postural Deficits

Causes of Multiple Sclerosis

          An epidemiological factor that researches say could play a role in MS is if an individual is predisposed to a certain environmental agent before puberty. Lifestyle choices can increase MS risk. Among the most studied environmental risk factors for MS are vitamin D levels, childhood obesity, and smoking. Vitamin D deficiency can influence MS risk early in life and obesity has been found to be critical for MS risk during adolescence.

An example of this would be a lack of sunlight which causes lower levels of vitamin D which is an important vitamin in immune system support. Finally, genetics may contribute to the possible cause of MS as the disease itself is not inherited but the risk factor of developing the disease.

Guillain -Barre Syndrome     

         Guillain-Barre Syndrome is a rare condition that affects the legs, feet and limbs causing weakness and pain.  If a person has this syndrome, they are expected to make a successful recovery although it can be very serious.  It affects people of all ages but it more commonly affects adult males.  This syndrome will develop over hours or days and tend to start in your feet and hands before spreading to your arms and legs. The symptoms of this syndrome are; numbness, pain, weakness in the limbs and balance and coordination exercises.  This syndrome affects the body bilaterally meaning both sides of the body are affected at the same time. If an athlete notices numbness or lower limb pain while playing a sport they are to immediately let their coach or the medical team know.  If an athlete has trouble speaking, breathing, swallowing or the inability to move their limbs they are to be rushed to the hospital immediately.  This syndrome is thought to be a problem of the immune system as the immune system begins attacking and damaging nerves. 

         The most common way a person can get this syndrome is if they had a recent infection like flus, food poisoning, HIV, Epstein Barr Virus, Zika Virus as well as if individuals were recently vaccinated for any of the disease, illnesses or viruses.  Most people recover from this syndrome and others develop long term health problems that require assistance from physiotherapists, nurses or counsellors.  There are other diseases that can mimic GBS; these illnesses and diseases are Lyme disease, Arsenic poisoning, Tick paralysis and Critical illness myopathy/neuropathy.      

Aims of Physiotherapy in Curezone Clinic, Mississauga

1. To re-educate and maintain all available voluntary control
2. Re-educate & maintain postural dysfunctions
3. Incorporate treatment techniques into ways of life by relating to ADLs
4. Inhibit abnormal tone and to stimulate all sensory and perceptual sensations

The assessment by the physiotherapist at curezone Physiotherapy- focus on posture, movement, and function, realise the patient’s performance may be limited by fatigue, pain or other factors. An individualized program can then be set up. This program needs must easily be performed at home, provide written instructions if needed. 

Aquatic exercise programs have a positive effect on persons with progressive multiple sclerosis. It promotes general health, improves energy levels and mental health, and aids social interaction in the presence of physical disability. Because of the reduced impact of gravity, aquatic training allows patients with even severe paresis of the lower extremities to perform standing and moving exercises. A systematic review and Meta-Analysis recommend combining aquatic therapy with conventional physiotherapy for MS patients^.

Specific balance exercises can improve balance. Poor postural control increases the risk of falls. MS patients have increased sway in quiet stance, delayed postural perturbations and reduced ability to move towards limits of stability. 

Motor Imagery is increasingly used in neurorehabilitation in-order to facilitate motor performance. Motor imagery and rhythmic auditory stimulation can be used for walking rehabilitation in MS patients.

• Patients with MS often experience pain directly from the disease, secondary to medication or other symptoms, or from something completely separate. Physiotherapy goals are to relieve pain through exercise, stretching, massage, ultrasound, postural training, or hydrotherapy.
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• Sensory Deficits. Tapping and verbal cues during exercise and resistance training can help improve proprioception. Vision issues, such as blurred or double vision, often occur in patients with MS. Or registered physiotherapist can offer education on how to be safe at home and offer strategies to improve balance and coordination in dim light settings. Physiotherapy treatment interventions for decreased sensation to light touch include education on awareness, protection, and personal care to desensitized body parts. Pressure-relieving devices are a primary prevention strategy along with proper transfer techniques and daily skin inspections for maintaining skin integrity.
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• The Physiotherapist will help patient to overcome the feelings of excessive tiredness include aerobic exercise, energy conservation, and activity pacing. Aerobic exercise activities are closely monitored by our Physiotherapist to ensure a patient does not overwork. Physiotherapist can also teach energy conservation strategies and activity pacing to help someone sustain their daily activities by minimizing fatigue.
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• The physical and functional limitations spasticity leads to include a variety of impairments which can present as contractures, postural deformities, decubitus ulcers, and more. Physiotherapy interventions range from cryotherapy and hydrotherapy to therapeutic exercise, stretching, range of motion activities, postural training, and electrical stimulation.
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• Balance, Coordination, & Postural Deficits. Ataxia, postural instability, muscle spasms, and generalized muscle weakness al contribute to balance and coordination deficits. Physiotherapy techniques to address these issues include postural exercise, core strengthening, rhythmic stabilization, static/dynamic balance training, aquatic therapy, proprioceptive loading, and resistance training
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• Mobility Issues. Weakness, particularly in the lower extremity, balance deficits, fatigue, posture, contractures, sensation deficits, heat intolerance, among other deficits, can impede an individual’s ability to be mobile. Locomotor training focuses on increasing thigh and hip strength along with posture and balance training through walking activities. Orthotics and assistive devices are added as necessary.

Dietary Modification

     Some preliminary research investigating inflammation-reducing diet which could help control chronic inflammation. Many researchers are exploring dietary intervention approaches in MS to improve lifestyle.

1. Probiotics may improve the health of people with MS by reducing disability and improving inflammatory and metabolic parameters according to an Iranian study. 2. Vitamin D supplementation may possibly assist in the prevention and treatment of MS however existing evidence is of very low quality. Various research studies are studying the effectiveness of vitamin D therapy in MS. 
2. Fish oil supplementation given together with vitamins and dietary advice can improve clinical outcome in patients with newly diagnosed MS. More research is required to assess the effectiveness of dietary interventions of omega 3 in MS and it’s interaction with ms.

https://multiple-sclerosis-research.org/2016/05/clinicspeak-intermittent-fasting/edications used for treating MS.

http://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Documents/Diet-and-Multiple-Sclerosis-Bhargava-06-26-15.pdf