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Aquatic therapy for multiple sclerosis

August 01, 2013

Multiple sclerosis (MS) is a neurodegenerative disorder that affects upwards of 400,000 people in the United States. Many people with MS have symptoms that include fatigue, difficulty walking, stiffness and spasms, pain and parasthesias, balance difficulties, and speech problems. Finding a way to safely and effectively manage many of these symptoms can be difficult.

Aquatic exercise programs promote strength, stamina and flexibility. It can minimize symptomatic complaints such as muscular fatigue, weakness, and spasticity. There are many research studies which indicate that aquatic exercise can increase work capacity, decrease fatigue levels, increase cardiovascular fitness, improve strength, improve balance, and improve self-reported quality of life.

The properties of water act in a way that allows individuals who may be restricted in their activities on dry land to perform a wide range of activities in the water. Buoyancy, the uplift force experienced in water, and gravity are opposing forces in the pool; so the deeper a body is submerged, the less weight the body bears. This means someone who has weakness in the legs such that they struggle to lift their legs to walk on land may be able to walk for exercise when in the pool. Buoyancy also reduces the joint compressive forces and allows movement and positioning with reduced pain and discomfort. It can also assist with movement and positioning for tasks like stretching and spasticity management.

Almost any exercise that can be completed on land can also be performed in the pool. This includes balance tasks, walking, aerobic activity, and strengthening. In combination with the properties of the water, tools such as kickboards, noodles, water gloves, fins, and pool dumbbells can be incorporated to assist movement, support movement, or resist movement.

Another important property is hydrostatic pressure, which is the idea that water exerts pressure in all directions. This means the deeper a person goes into the water the more pressure is being placed on the body. Hydrostatic pressures act not only upon the body parts, but can also affect the blood flow and work required to breathe. So, someone who is anxious or has heart or lung problems is likely better served in shallow water minimizing the demand on the lungs and circulatory system; but for those comfortable in the water, hydrostatic pressures can be used to provide increased support to stand, ambulate, and balance in the water. It can also potentially assist with swelling, pain, and some sensory hypersensitivity.

An important note is that due to heat sensitivity in many individuals with MS, it is important that the water temperature remain below 84 degrees. Recommended temperature range is between 80-84 degrees.

Aquatic therapy is an excellent way for individuals with MS to experience exercise and activity in a gravity-decreased environment, making it easier to exercise and improve cardiovascular fitness, strength, and balance.