Grades the resistance encountered during passive stretching to quantify spasticity.
Compensation and preservation. Focus on gait retraining, advanced transfer training, falls prevention, and the prescription of appropriate assistive devices or functional electrical stimulation (FES) for foot drop. Severe Disability (EDSS 7.0 – 9.5)
Balance, Coordination, and Gait Training Techniques. Slide 7: Managing Spasticity and Hydrotherapy Protocols. physiotherapy management of multiple sclerosis ppt upd
[ Aerobic Exercise ] [ Resistance Training ] • 2-3 Days / Week • 2 Days / Week • 40% - 60% VO2 Max • 60% - 80% 1RM • Cycling, Walking, Aquatics • Multi-joint Compound Moves Neuroplasticity-Driven Balance and Ataxia Management
Physiotherapy interventions must target specific impairments using evidence-based parameters. Severe Disability (EDSS 7
Focuses on large muscle groups to combat neurogenic weakness.
| Stage (EDSS) | Focus | Example Intervention | |--------------|-------|----------------------| | Mild (0–3.5) | Maximize fitness & community mobility | HIIT cycling, group balance class | | Moderate (4–6) | Maintain walking & manage fatigue | Treadmill + cooling vest, home exercise program | | Severe (6.5–8) | Preserve transfers & prevent contractures | Caregiver training, passive ROM, power wheelchair mobility | | Advanced (>8) | Positioning, respiratory health, skin integrity | Seating assessment, assisted cough, pressure relief | Focuses on large muscle groups to combat neurogenic weakness
(e.g., AI-driven monitoring or online classes) is now considered most effective for long-term adherence. Multidisciplinary Approach:
: Break tasks into small chunks with rest periods in between.