Summary phys. theory: evidence in MS

Phys. Theory:MS: evidence based MS physical rehab
Evidence-based Physical Rehabilitation with multi-dimensional effects

 Rehabilitation in MS: a systematic review of systematic reviews (Khan et al 2016)
- Included 39
 Cochraine: 15
 Other :24 met 2 reports
- Cochraine review van alle oude cochraine reviews
- Hoogste evidentie
 Oefentherapie (wandelen & fatigue)
 Physical therapy
 Fatigue management programma’s
- Matige evidentie
 Spasticiteit management
 UL training
 Energie consevatie
 Multi-disciplinaire behandeling
 Cognitieve training
 Neuropsychologische reva
 Vocational reva

 What’s matters in rehabilitation is ‘functioning’
- Thompson et al. (2022)
- Accumulating & multisymptomatology in more disabled PMS




 Exercise is an effective symptomatic treatment
- Exercise and lifestyle physical activity recommendation for people with MS troughout the disease course
(kalb et al)
- Lifestyle, exercise and acivity pachage for people living with progressive MS (LEAP-MS): protocol for a single
arm feasibility study (latchem-Hastings et al)
- Dalgas et al. 2019 (graf)
 Aerobiic capacity
 Stregth
 Information progression
speed
o MET
o PASSAT



 EXERCISE THERAPY
- Input (stimulus) → blackbox → output (response)
- What are we doing? How often do we need to do it?

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, Phys. Theory:MS: evidence based MS physical rehab
- Exercise is quantifiable PT isn’t, we need to clarify what we do
 GUIDELINES AVAILABLE FOR EXERCISE IN MS
- Multiple sclerosis and physical exercise: recommendations for
the application of resistance, endurance and combined
training (Dalgas et al)
- Developpment of evidence informed physical activity
guidelines for adults with MS (Latimer-Cheung et al)
- See also Pearson et al (2015) . Clinical Rehabilitation, On
physical activity




 FUNCTIONAL- AND NEUROLOGICAL RESERVE
- Y-as= functonele reserve
- X-as= tijd
1
- Start grafiek (1) 2
 Alle lijnen nog samen
 Op moment diagnose
 Genoeg brain reserve
- Daling (2)
 Atrofie hersenen
- Disability = EDSS
- Groene kader
 Nog wat tegenspraak over oefentheraîe dat
hersenen beschermt in MS
o Use it or losei t
- Medical treatment
 DMD

 Exercise as Medicine to reduce symptoms
- U Dalgas et al. Exercise as Medicine in Multiple Sclerosis—Time for a Paradigm Shift: Preventive,
Symptomatic, and Disease-Modifying Aspects and Perspectives. (2019)
- /w/ training= ↑kracht
- Aerobic training (VO2 max)= ↑aerobic capacity
- Balans ↑ bij krachttraining




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