ubsequent appointments will focus on neurological physiotherapy tailored to the client’s individual needs and goals. Sessions will usually last 50–60 minutes and will aim to help people with multiple sclerosis maintain their physical abilities, manage symptoms, and remain as independent as possible.

Treatment for MS may include:

• Massage and hands-on treatment: To help manage muscle tightness and improve comfort, where appropriate.
• Stretching and mobilisation: To maintain joint movement, flexibility, and comfort.
• Movement exercises: To support muscle strength, balance, coordination, and mobility.
• Functional activities: Practising everyday movements to help maintain independence and confidence.
• Balance and walking exercises: To support safe mobility where appropriate.
• Fatigue management: Providing advice on pacing activities, managing energy levels, and balancing activity with rest.
• Personalised exercise programmes: Recommending suitable exercises and activities to maintain physical function between sessions.

Physiotherapy for multiple sclerosis will be adapted to the client’s symptoms, energy levels, and abilities. Treatment will aim to maintain function, manage the impact of symptoms, and support quality of life. Although physiotherapy cannot stop the progression of MS, it can help people manage its effects and maintain mobility and independence where possible.

Advice and guidance will also be provided to family members and carers where appropriate, including practical ways to support movement, comfort, and daily activities.

Advanced Stages of Multiple Sclerosis:

As multiple sclerosis progresses and mobility or independence changes, additional support may be needed to maintain comfort, safety, and quality of life.

Where required, the physiotherapy assessment may include:

• Bed positioning: Assessing comfort, posture, and support when lying down.
• Wheelchair positioning: Checking posture, stability, comfort, and body alignment.
• Movement and handling: Providing advice on safe movement, transfers, and assistance with daily activities.
• Pressure care: Considering positioning and support to help reduce the risk of pressure-related problems.
• Wheelchair and seating support: Identifying whether specialist equipment or further assessment may be needed.
• Wheelchair Services referrals: Providing assistance with a referral if additional wheelchair or seating support is required.

Overall Aim

The aim of neurological physiotherapy for multiple sclerosis is to help clients manage the physical effects of MS, maintain movement and function, and support independence for as long as possible.

Treatment will be tailored to each client’s individual needs, with a focus on:

• Maintaining mobility and physical abilities.
• Managing muscle stiffness and discomfort.
• Supporting balance, posture, and coordination.
• Helping manage fatigue and daily activities.
• Promoting comfort and safe positioning.
• Supporting independence and quality of life as multiple sclerosis changes over time.

Progress and treatment needs will be reviewed regularly to ensure that physiotherapy remains appropriate for the client’s condition and goals.