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Multiple sclerosis is a chronic, progressive disease caused by the demylination of the central nervous system (CNS) Motor deficits in multiple sclerosis (MS) affect not only the limb muscles, but also the ventilatory muscles, both in terms of decreased strength and endurance. Just as muscular weakness in the limbs occurs early in the disease and increases as the disease progresses, the same progressive weakness occurs in the ventilatory muscles. Ultimately, respiratory complications are considered the major cause of morbidity and mortality in individuals with advanced MS. Patients with MS show a poor exercise tolerance, with fatigue and dyspnea on exertion, which limits their ability to perform activities of daily living (ADL) Physiotherapy has a major role in training of respiratory muscle strength and endurance by using different resistive breathing devices.
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