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Minimal Guidelines: Aerobic: 2x per week (30 mins moderate intensity). Strength: 2x per week (8–10 exercises, 2–3 sets). Advanced Guidelines (for higher function): Aerobic: 5x per week (30–40 mins moderate to vigorous). Resistance: 2x per week of major muscle group targeting. Slide 6: Management of Common Symptoms

Identifying ataxia, foot drop, or circumduction. Berg Balance Scale: Assessing fall risk.

Detailed history of relapse vs. progression, fatigue levels (Modified Fatigue Impact Scale), pain, and cognitive issues. Physical Examination:

Effective physiotherapy management for Multiple Sclerosis (MS) has shifted from energy conservation to a . Recent 2025–2026 clinical perspectives emphasize technology integration, telerehabilitation, and individualized exercise dosing. Presentation Content Outline 1. Introduction & Pathophysiology

MS fatigue is a cellular, central nervous system issue, not simple laziness.

Prescription of canes, walkers, or functional electrical stimulation (FES). Neuroplasticity and Motor Learning

Focus on high-intensity preventive conditioning, complex balance tasks, and neuroprotective strength training to build functional reserves.

Current guidelines recommend a minimal dose of 2–3 days per week of both aerobic and resistance exercise training to safely benefit from exercise in MS. Based on the National MS Society, a progressive target of at least 150 minutes per week of exercise or lifestyle physical activity is recommended, with adjustments based on individual capacity, symptom status, and comorbidities. Exercise sessions should typically be scheduled during patients’ peak energy periods, with frequent rest breaks to prevent symptom exacerbation.

Shift goals toward passive stretching to prevent contractures, proper positioning to avoid pressure ulcers, respiratory physical therapy, and training caregivers on safe transfer techniques. 7. Interdisciplinary Collaboration

Advanced Gait Training & FES (Foot drop management and assistive technology).

Comprehensive Physiotherapy Management of Multiple Sclerosis (2026 Update) 1. Introduction and Epidemiology