Saturday, June 23, 2012

Battling Multiple Sclerosis: Integrated Advanced Techniques

The title of this post speaks for itself and needs no particular introduction.  However, as part of the One Giant Leap objectives, no amount of information is too much...therefore I will start this very exciting post with a brief introduction to Multiple Sclerosis (MS) itself, followed by more detail specifics on the particular ¨strategic campaign¨ for addressing some of the challenegs associated with MS.

The National Multiple Sclerosis Society defines MS as: a chronic, often disabling disease that attacks the central nervous system (CNS), which is made up of the brain, spinal cord, and optic nerves. Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. The progress, severity, and specific symptoms of MS are unpredictable and vary from one person to another. MS is tought to be an auto-immune disease...which means the body’s own defense system attacks myelin, the fatty substance that surrounds and protects the nerve fibers in the central nervous system. The nerve fibers themselves can also be damaged. The damaged myelin forms scar tissue (sclerosis), which gives the disease its name. When any part of the myelin sheath or nerve fiber is damaged or destroyed, nerve impulses traveling to and from the brain and spinal cord are distorted or interrupted, producing the variety of symptoms that can occur.

There are essentially four (4) courses of MS (remitting-relapsing, primary-progressive MS, secondary-progressive MS, and progressive-relapsing MS).  Each individual typically experience either mild, moderate, or severe symptoms of one of the four courses.  Although each is different (in frequency and manifestation), the objective of this post is to consider all of them as one and therefore the fundamental strategy is universal.

One of the main challenges for people with MS is the development of chronic inflammation and lymphedema.  The document embedded at the end of this post goes into more detail, however it summarizes lymphedema as the accumulation of lymphatic fluid in the interstitial tissue, resulting from a failure of the lypmhatic system to return fluid to the circulation despite normal capillary filtration.  This characteristic is fundamentally global in nature, however due to the lack of mobility that is often accompanied with MS (as well as the effect of gravity), inflammation usually develops in the feet and ankles.  When not properly addressed, this fluid remains stagnant and therefore reduces oxygen transport capacity, reduces wound healing, and creates a culture medium for bacteria.

There are many intervention available for the treatment of lymphedema and chronic inflammation ranging from manual massage, elevation, pumping systems, and compressional devices.  In effect, the many different strategies reflect the importance of addressing this challenge as effectively and efficiently as possible.  It is with this global objective in mind that I have integrated two (2) proven effective techniques to form the Activ8 System for Multiple Sclerosis. 

Richard Paletta and Gavin Broomes
I am very pleased and excited to have the help of Richard Paletta, licensed Kinesiologist and Physiotherapist, who brings years of practical experience and dedication to the fascial paradigm to the clients of his clinic REB (Rehabilitacion Estructural Biotensegral), in Rosario, Argentina.  In addition, I would also like to thank our MS patient from REB for their time in helping us prepare this post and enable us to deliver this valuable information.

The Activ8 System for MS is comprised of two (2) fundamental branches:  Functional Kinematics (Exercise) and Systemic Health Development (improving systemic homeostasis).    This post will demonstrate a specific strategy within the systemic health development strategy.  The two proven techniques that comprise this strategy are:  1) Trans-Fascial Viscoelastic Stimulation (TFVES), and 2) Therapeutic Elastic Taping (commonly referred to as Kinesiotaping.

As per my description of TFVES in a previous post, it is an innovative technique used in the treatment of children with Cerebral Palsy and other disorders of movement and posture.  Using various stress-transfer mediums, the practitioner is able to access the connective tissue / fascia at all levels including the very deepest visceral / core level.  TFVES is a very comprehensive set of skills, applications, guidelines, and targets that require an extensive process of learning and development...however the overwhelming scientific and clinical evidence shows that is produces extraordinary benefit and contribution to the improvement of connective tissue strength, health, integrity, and homeostasis...therefore reducing fascial dysfunction and the reduction of abnormal pain signalling.  In addition to the enormous systemic benefit, there is also a very significant improvement in the overall health, strength, and integrity of the connective tissue system which contributes to structural integrity and therefore improves functional performance.  


Also as per my previous post on Kinesiotaping, this techniques is very adaptive and addresses both functional and systemic rehabilitative objectives.  
 Kinesio Taping alleviates pain and fascilities lymphatic drainage by lifting the skin. The taped portion forms convolutions in the skin thus increasing interstitial space. The result is that pressure and irritation are taken off the neural/sensory receptors. Then, slowly, pressure is taken off the lymphatic system allowing it to drain more freely.  I recommend that you refer to my previos post on the role of Kinesiotape in the contribution to improved lymphatic drainage to get a more expanded and detailed explanation of the mechanism.  


The systemic development session begins with the application of case-specific elastic tape applications.  The tape is applied and can remain on the skin for up to 5 days and resists water and sweat, therefore it does not interfere with bathing and other activities associated with daily life.  


Low Back / Lumbar
Shoulder / Thorax
The first application is applied in a seated position and oriented to direct flow from the pelvis and periphery to the center.  The second application is done in a prone position and is applied from the acromion process (shoulder) to the mid-thorax adjacent to the spine.  Both applications serve to promote lymphatic drainage, however the shoulder application serves a secondary function of providing some minor elastic facilatation during movement of the arms.  



Application of elastic tape


The applications for the elastic tape are quite varied and, as mentioned previously, are case-specific as well as objective-specific...therefore a significant number of variations and combinations exist.  These particular applications are specific to this case and are representative of the specific objectives of the case.






Case-specific TFVES application

The image on the left is an example of a case-specific TFVES application.  This particular application is being performed to serve the treatment objectives of improving lymphatic drainage, strengthening the connective tissue superstructure, and contributing to the overall development and maintenance of systemics homeostasis.  The set of images below demonstrates the dynamic stretch and elastic contribution the shoulder application provides during active movement.








In summary, the challenges with chronic inflammation in people with MS can be significant.  However, every case of inflammtion from mild to severe can be addresed with focused implementation of specific goal-oriented strategies.  We will continue to follow this case and provide you with the additional strategies that will be in place for the reduction of inflammation in the legs as well as the evolution of the implementation of the Systemic Health Development protocol.


More to come!  Cheers!






Lymphatic System and MS_National MS Society_2011

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