如何与MS锻炼：物理治疗师的建议

在多发性硬化症（MS）的人中，可能出于多种原因出现流动性问题，但主要原因之一是柔韧性和力量丧失。通过通过物理疗法和运动解决这些缺陷，MS的人可以显着提高步行能力和balance.

Strength and mobility deficits in MS can occur for two principal reasons, and it's important to recognize the difference between the two:

• 主要缺陷力量和灵活性直接归因于疾病活动 - 也就是说在大脑和脊髓脱髓鞘.
• Secondary deficits are caused chiefly by inactivity and a sedentary lifestyle, leading to muscles and joints becoming weaker and tighter.

Both can lead to an inability of the muscles to function efficiently and result in worsening of gait, balance, and other mobility tasks.

Since secondary deficits are due primarily to lack of exercise, they can be reversed significantly simply through starting an exercise program. But the rules for exercise for persons with MS are not the same as for people who don’t have MS.

此外，对于每个MS的人来说，强度和灵活性的丧失将有所不同。因此，需要每个人的个性化锻炼计划。熟悉MS的物理治疗师可以帮助制定这种个性化的程序。

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How to Maintain and Increase Flexibility

为了使肌肉以最大的效率发挥作用，他们必须能够通过全方位运动。当肌肉“紧绷”时，它们将无法整个范围内移动。结果，步行等动作受到限制，平衡可能会受到损害。

Being sedentary is a very common reasonpeople with MS失去肌肉灵活性：缺乏肌肉运动会导致肌肉变得短而紧。

MS肌肉紧绷的另一个原因是软弱。肌肉通常成对成对 - 例如，二头肌位于手臂的前部，背面的三头肌。如果二头肌弱，则三头肌会变得过于活跃，因此无法穿越其全范围。

Yet another reason that persons with MS may lose flexibility is spasticity. Spasticity is a type of abnormal muscle stiffness that occurs as a result of the brain signaling a muscle to contract when it shouldn’t. Over time, that muscle gets tighter and tighter. Physical therapy can help with the resulting muscle stiffness, but treating the spasticity itself usually requires medication prescribed by a physician.

Having a full range of motion is critical for daily functions. Common areas where muscle tightness occurs are the plantar flexors (calf muscles), the muscles on the backs of the thighs (hamstrings), and the muscles at the front of the hip area (hip flexors).

足底屈肌的紧密度会导致脚下，这是MS跌倒的主要来源。腿筋的紧绷性会导致难以迈出一步，而臀部屈肌的紧密度可能会导致“蹲伏”步态。

这些区域中的任何一个都可能会使平衡恶化并阻碍正常的步行。但是所有这些都可以改进，并通过包括stretching.

Instead of performing an intense stretch for a short period, it’s much better to hold a gentle stretch for a prolonged period. This allows the muscle to stretch slowly and decreases the risk of the muscle tearing.

一个physical therapist can show you which muscles specifically need to be stretched, and the best ways of performing that stretch.

RELATED:MS Muscle Spasticity: What It Is, and What to Do About It

How to Build Muscle Strength When You Have MS

Strength is the ability of muscles to generate force against a certain resistance. The resistance doesn’t have to be massive weights — in fact, the resistance that often is the most troublesome to those with MS is one that everyone experiences all the time: gravity.

肌肉必须足够强大，以克服这种力量，以便能够直立。如果您没有足够的腿部力量，则不可能从椅子上升起或踩到路边。

As previously noted, some of the decrease in strength seen in people with MS is due to the effects of the disease: Because of demyelination, more energy is needed to produce the same amount of force.

但是通常，大多数力量损失是由于肌肉消失造成的，这是锻炼可以产生巨大影响的地方。

不管原因是什么，如果适当解决强度的损失，它可能会改善运动和减少疲劳。

有很多表演的方法力量训练, including lifting weights, using elastic resistance bands, or using the resistance of water or simply your own body weight.

但是有时候解决力量障碍的最佳方法是执行缺乏力量的任务。例如，如果有MS的人很难从椅子上起床，那么练习起床是变得更好的最好方法。如果根本不可能，可以对任务进行修改以使其更容易，例如提高椅子的高度或用上身推开扶手。

力量训练的结果将导致力量增加和疲劳的减少。

如何处理疼痛和疲劳

Some unpleasant, exercise-induced symptoms can occur when starting an exercise program. After strength training, muscles can be sore, and legs and arms can feel heavy after an intense workout. If feelings of soreness and heaviness last longer than 48 hours, you should scale back your strength training program.

疲劳是最常见的symptom of MS，并且显然会发生锻炼，但是有多种方法可以最大程度地减少其影响。例如，寻找保持凉爽的方法working out，当您自然拥有更多能量时锻炼可以帮助最小化fatigue associated with exercise.

RELATED:PT如何帮助MS相关疲劳

达到平衡：不太容易，不要太难

锻炼不应该太容易了。这应该具有挑战性。如果太容易了，那将不会导致任何有意义的变化。但是，如果它太具有挑战性，您将无法完成它。

Striking a balance between too intense and not intense enough requires an individualized plan that takes into consideration the frequency, intensity, and duration of each exercise session.

熟悉MS人员的特定需求的物理治疗师可以帮助您解决这个问题。除了物理疗法课程外，重要的是要跟上按照进展规定的定期更新的家庭锻炼计划。

The most important thing is to remember that if you don’t use it, you lose it. If you stop performing activities, they will become progressively harder, and what you are able to accomplish physically will continue to diminish. With the right program and dedication to training, you will see the positive effects of exercise.