I have quite a bit of experience with clients with MS. Usually one side is impacted more than the other, and because of a series of falls, there are usually significant imbalances in addition to the neurological problems caused by MS.
I found that the first step is to strengthen all muscles as much as possible. Some areas may not immediately respond but with patient you may be able to build greater strength and thus a certain degree of confidence.
A client with severe balance issues will only improve existing compensations if you try balance exercises first. With one of my clients, I did strength (which is a very relative term with MS) for quite a while before even asking her to balance on anything. Eventually, I saw great improvements which were also in terms of confidence in the functioning of her body.
I would start very gently and rather ask too little than too much. Every exercise session should produce a feeling of “Wow, look what I CAN do!”
I wrote this on the assumption that you have medical clearance to work with your client. You client may also have seen a physical therapist who you should try to contact.
I wish you and your client all the best.
As always with training a client with medical issues make sure you are in communication their medical doctors and have do’s and don’t for this client.
I do balance work with all of my clients and find it essential.
I always make sure the area is clear of possible hazards and I always stand next to my client in case they need to “hold on”. I suggest that they immediately stop the balance work if they feel as if they are going to fall.
With MS it depends on the severity and restrictions. Starting balance work while seated would be a good way to introduce picking one foot up off the ground. Once they feel comfortable with this the next move would be to do it while standing and holding on and progress from there
Balance work can and is frustrating for many people. Remember to encourage and know when to back off if they are feeling overwhelmed.
Working with someone is a very delicate situation, as you probably know. Before doing anything, I would do some PNF patterns and trunk stabilization exercises with that person first. Only after that, would I do balance exercises such as:
Sitting Balance on SB (1leg on floor)
Do the same exercise; except this time, the client has his/her eyes close.
As the person gets better, then the balance execise should get a little more proactive, such have the person sit on the SB and apply a gentle pressure to the client to provoke balance.
Best of luck
Very helpful for MS stretching and range-of-motion exercises, coupled with correct positioning, may relieve the spasticity resulting from opposing muscle groups rellaxing and contracting at the same time; helpful in relaxing muscles and maintaining function.
Also helpful freguent rest periods, aerobic exercise, and cooling techniques (air conditioning, breezes, water sprays) may minimize MS.Changes in enviromental conditions, such as heat and humidity, can aggravate MS.
Adaptive devices and physical therapy help with motor dysfunction, such as problems with balance, strength, and muscle coordination.