Multiple Sclerosis Physiotherapy & Exercise Resource Centre

Multiple Sclerosis can affect people very differently. Physiotherapy therefore works best when exercise and rehabilitation are matched to your current symptoms, mobility, fatigue and goals rather than following one fixed programme.

This resource centre brings together practical MS physiotherapy topics in one place. It is designed for people who are newly diagnosed and active, people managing fatigue or changes in walking and balance, and people who may need seated, wheelchair or more supported rehabilitation.

Multiple Sclerosis exercise, fatigue, strength and balance

Exercise can include aerobic activity, resistance training, balance work, mobility and task-specific practice. The right starting point depends on your current ability. Fatigue and heat sensitivity may mean the dose, timing or type of exercise needs adapting rather than abandoning activity altogether.

Read: MS exercise, fatigue, strength and balance for practical ways to structure activity and progression.

Foot drop and walking in MS

Foot drop can make the front of the foot harder to clear during walking. Physiotherapy may address ankle and leg strength, gait strategy, balance and secondary movement changes. Some people may also benefit from assessment for orthoses or functional electrical stimulation depending on the cause and presentation.

Read: Foot drop in Multiple Sclerosis for physiotherapy, exercise and walking strategies.

Balance, falls and walking confidence

Balance problems can be influenced by weakness, sensation, vision, dizziness, coordination, fatigue and the demands of dual-task walking. Rehabilitation may therefore combine strength, balance, stepping, walking and environmental strategies rather than relying on one exercise.

Read: Balance and walking in Multiple Sclerosis for progressive rehabilitation ideas and safety considerations.

Rebuilding activity after an MS relapse

After a relapse, function and energy can take time to settle. The rehabilitation priority is not automatically to return to the previous exercise level immediately. It may be more appropriate to reassess symptoms, rebuild everyday activity and gradually progress strength, balance and endurance with input from the MS team where needed.

Read: MS relapse recovery, physiotherapy and exercise for a staged approach to rebuilding activity.

What can an MS physiotherapist help with?

A physiotherapist can assess strength, movement, balance, walking, transfers, fatigue-related movement problems, spasticity and physical function. Treatment may include targeted exercise, gait and balance rehabilitation, advice about mobility aids, pacing, positioning, task practice and referral for other equipment or specialist input where appropriate.

Adaptable rehabilitation matters

There is no requirement to be able to stand or walk independently to benefit from rehabilitation. Exercise can be adapted to bed, supported sitting, wheelchair, supported standing, home exercise, gym training and higher-level fitness depending on what is appropriate for the individual.

Trusted information

MS Trust information on fatigue, balance and foot drop provides further UK-based information. UCLH also describes specialist MS physiotherapy, mobility and fatigue-management support.

When to seek individual advice

MS is variable and exercise needs to be adapted to the individual. New or worsening neurological symptoms, a suspected relapse, repeated falls, sudden changes in walking or significant new weakness should be discussed with your MS nurse, neurologist, GP or other appropriate healthcare professional. A physiotherapist can assess movement, strength, balance and mobility and tailor rehabilitation to your needs.

Explore the complete MS guide

The Complete Multiple Sclerosis Physiotherapy & Rehabilitation Guide is a 353-page digital resource with 91 progressive exercises, video demonstrations and detailed sections on fatigue, strength, balance, walking, foot drop, spasticity, relapse recovery, wheelchair and seated rehabilitation, gym exercise and self-management.