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Multiple sclerosis behaves differently in every person, and changes in the same person from one period to the next. On this page we have put together a straightforward explanation of what happens in the body, why the old advice to avoid exertion has been reversed, and how to work around fatigue and heat sensitivity without overloading.
Multiple sclerosis is an autoimmune disease of the central nervous system. The immune system mistakenly attacks the myelin, the insulating layer that wraps the nerve fibers. Myelin is what allows the electrical signal to travel quickly and precisely along the nerve.
When that insulation is damaged, the signal arrives more slowly, distorted, and sometimes not at all. Think of it like an electrical cable whose coating has cracked. The cable is still there, but the conduction is no longer reliable.
Two points follow from this that are important to understand. First: the muscles themselves are healthy. What is damaged is the transmission of the command to them. Second: the location of the lesions in the nervous system varies from person to person, which is why multiple sclerosis presents so differently. For one person it is mainly a walking problem, for another sensation or vision, and for a third, fatigue is the dominant symptom.
Here too, a secondary cycle develops that worsens over time and does not stem directly from the disease: movement decreases because of fatigue or apprehension, so the muscles weaken and lose mass, ranges of motion shrink and balance suffers. These make movement even harder. This cycle can genuinely be influenced, and that is exactly what rehabilitation targets.
If you were diagnosed years ago, you may have been told to avoid exertion. That advice was common, and it came from a concern that physical effort would worsen the disease or trigger relapses.
That thinking has changed. What became clear is that the worsening of symptoms during exertion is linked mainly to a rise in body temperature, not to neurological damage, and it passes as the temperature comes back down. Today, structured, properly adapted physical activity is considered a recommended component of managing the disease, and studies show support for improvements in muscle strength, balance and walking endurance.
The practical takeaway is not that you can train without limits. The key is adaptation: the right intensity, short sets instead of prolonged effort, and control of heat and time. More on that below.
An increase in muscle tone that shows up as stiffness, resistance to movement and sometimes spasms. It is one of the most common symptoms in multiple sclerosis, and it directly affects walking, dressing and sleep. Spasticity is not weakness, so it calls for a different approach: not just strengthening, but also work on regulating tone and on range of motion.
Usually more pronounced in the legs and pelvis, affecting stair climbing, rising from a chair and the ability to keep going while walking. Part of the weakness comes from the disease itself and part from the secondary cycle of reduced movement, and that second part is precisely the one that can be influenced.
These stem from damage to the pathways responsible for the sense of position in space and for coordinating movement. The result is instability, more cautious walking and a fear of falling, which restricts movement even further.
Not necessarily difficulty walking, but difficulty keeping it up over distance. That is why an accepted measure in assessing multiple sclerosis is the six-minute walk test, which checks how much distance is covered in continuous walking, not just whether walking is possible.
These are the two issues that dictate, more than anything else, what treatment in multiple sclerosis needs to look like, which is why they get their own section here.
Fatigue in multiple sclerosis is the most common complaint, and it is different from ordinary tiredness. It is not proportional to effort, does not always pass after rest, and can appear without warning. It is also the main reason training programs fail: they simply demand more than there is.
The practical principle is short sets with breaks, instead of one prolonged effort. The goal is quality of activation, not length of time.
For many people, a rise in body temperature causes a temporary worsening of symptoms, from blurred vision to increased weakness. It sounds frightening, but it is important to understand: this is a temporary worsening, not damage, and it passes once your temperature returns to normal.
In practice, this means treatment needs to be planned with air conditioning, hydration, breaks and short sets. If you have this kind of sensitivity, it is one of the most important things to tell us at your first appointment.
The previous section leads to a demanding requirement: you need meaningful muscle activation, but in a short time and without raising body temperature. That is exactly where this method becomes relevant.
This is not a treatment performed on you while you lie passively. The method is based on a gentle, controlled movement that mimics the natural walking pattern. The nervous system recognizes it and responds with reflexive muscle contractions, dozens of times per second. The practical meaning: a large number of muscle activations within just a few minutes, without prolonged aerobic effort and without loading the joints.
Three stages, paced by your functional ability, not by a one-size-fits-all protocol.
A first appointment in which we assess functional status, spasticity, balance and medical limitations. In multiple sclerosis we look especially at fatigue levels and heat sensitivity, and the structure of the sets is built from these.
The treatment is short and divided into sets with breaks, so as not to overload and not to raise body temperature. A physiotherapist accompanies you throughout, correcting position and adjusting the intensity in real time.
The load increases gradually according to your actual response, including how your fatigue responds the next day. We measure and document so improvement can actually be seen, rather than relying on feel alone.
Galileo (made by Novotec Medical, Germany) is the device that invented side-alternating vibration and the most researched of its kind in the world. Below are findings from studies published in scientific journals on whole-body vibration training in multiple sclerosis.
A randomized controlled pilot study of 30 people with progressive multiple sclerosis, using the very same Galileo Med 25 TT platform, found an increase in walking distance on the six-minute walk test (about 38 m), alongside patient reports of a positive effect related to spasticity.
BMJ Neurology Open, 2026 · randomized controlled pilot studyA systematic review and meta-analysis of 14 randomized studies (393 participants with multiple sclerosis) found a significant advantage for vibration training in improving balance (P=0.03) and walking endurance (P=0.01).
Frontiers in Aging Neuroscience, 2022 · systematic review and meta-analysisA randomized clinical trial in people with multiple sclerosis, using the Galileo platform, found a significant improvement in the physical component of quality of life (SF-36 questionnaire, P=0.013), alongside improvements in additional functions.
International Journal of MS Care, 2022 · randomized clinical trialA systematic review and meta-analysis of 7 controlled studies (201 participants with multiple sclerosis) found a statistically significant improvement in quadriceps muscle strength (P=0.003).
Multiple Sclerosis and Related Disorders, 2016 · systematic review and meta-analysisThe findings refer to study groups and are not a guarantee of individual results. Nothing here is a substitute for medical advice or for your medication.
It is not right for everyone, and that is fine. Here is the picture as it is, so you can come to the appointment with the right expectations.
The screening list is not an automatic list of exclusions, but a set of issues clarified at the assessment appointment, and sometimes with your treating physician. The decision whether to start, and at what intensity, is made individually. In any case, we recommend informing your treating neurologist before starting any new treatment.
For years, the standard advice was to avoid exertion for fear of worsening the disease. That thinking has changed. What became clear is that the worsening of symptoms during exertion is linked mainly to a rise in body temperature and passes as the temperature comes down. Today, structured, properly adapted physical activity is considered a recommended component of managing the disease. The key is getting the intensity and duration right, not avoidance.
Fatigue is the most common complaint in multiple sclerosis, and it is factored into how the treatment is planned. The principle is short sets with breaks, rather than one prolonged effort. The method delivers a large number of muscle activations within just a few minutes, which makes meaningful work possible even in a short session.
Heat sensitivity, known as Uhthoff's phenomenon, is common in multiple sclerosis. A rise in body temperature can temporarily worsen symptoms, and the effect passes once your temperature returns to normal. It is a temporary worsening, not damage. We account for this in the plan: short sets, breaks, air conditioning and hydration. It is important to tell us about this kind of sensitivity at your first appointment.
During an active relapse, this type of treatment is not started or continued. You should wait until your condition stabilizes and coordinate with your treating neurologist. The rehabilitation is suited to the periods between relapses and to a stable condition.
Spasticity is one of the central targets in multiple sclerosis rehabilitation. A randomized controlled pilot study using the Galileo Med 25 TT platform in people with progressive multiple sclerosis reported a positive effect related to spasticity, alongside an increase in walking distance. The findings refer to study groups and are not a guarantee of individual results.
In many cases, yes. The treatment can be given seated, lying down or in supported standing, and the upper body can also be worked using therapy handles. Position and intensity are set according to your actual functional ability, in an individual assessment.
No. It is a tool within a rehabilitation process, not a substitute for medication or neurological follow-up. It works alongside physiotherapy and the other treatments prescribed for you.
In many cases, partial reimbursement is available through supplementary health plans or private insurance, depending on the terms of your policy. We issue a treatment confirmation and receipt so you can submit your claim. More about reimbursement
That is exactly what the assessment appointment is for. We will go over your functional status, tell you honestly whether we think there is value here for you, and if not, we will say so. You can also simply call and ask.