Four Hot Topics:Balance, Fatigue Spasticity and HeadacheMonique M. Canonico DOAssistant Professor, John A. Burns School of Medicine

2014 Lecture Series- NMSS

Overview

Balance Fatigue Spasticity Headache

Balance

Balance issues may affect over 50% of people living with ms

Study was done in 2008 by Cameron et al Tested by SSEPs Subjects with MS demonstrate differences

in the delay in postural response latencies between their two legs

4 Strengthening and Balance Exercises to Try at Home

1 Heel raises/toe raises: Stand up on tippy-toes and hold for 5 seconds, lower, and then rock back on your heels by lifting your toes up, and hold for 5 seconds. Do this 10 to 15 times. 2 Leg balance: Stand on one leg and hold for up to 30 seconds. Add in challenges like raising your arms to the side or holding overhead to make the exercise more difficult. Repeat this on a variety of surfaces, such as tile, carpet, and standing on a foam cushion to strengthen the connections between physical movement and mental association. 3 Foot exercises: Toes and feet play an important role in balancing. Use your toes to pick up small objects, like marbles or tissues, off the floor. This strengthens the calf and intrinsic muscles of the feet. Do this 5 to 10 times on each side. 4 Balance: Walking in a heel-to-toe pattern forward and backward. Take 5 to 15 steps in each direction. As you train, be aware of your MS symptoms. Challenge yourself but do so in a safe environment

What is a pseudoexacerbation?

There is no evidence whatsoever that exercise in persons with MS can lead to an exacerbation. As a matter of fact, in studies of persons with MS who exercise aggressively there was no higher incidence of exacerbation than non-exercisers.

Tai Chi

Tai Chi is a wonderful approach to balance training. The research has been very, very clear that persons with MS, when they use Tai Chi as balance training that it does improve their balance.