Salman Nazary-Moghadam - Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

Chronic neurodegenerative conditions, such as MS, result in a loss of physical and cognitive function from the destruction of neurons andfrom a lack of activation of the affected systems. People with MS experience physical and cognitive impairments potentially leading to inactivity and resultant deconditioning. This often becomes a cycle that is difficult to break. One question that frames the rehabilitation strategy chosen is whether the focus should be compensation for or restoration of lost function. Materials and Methods: Compensation includes interventions such as wheelchairs or walkers to assist with mobility or braces for absent or inadequate muscle power. Restoration is aimed at increasing the capacity of the system-for example, maximizing cardiovascular endurance by increasing maximal oxygen uptake orrestoring full ROM. Results: Prescribing programs, activities, and exercises that provide an adequate stimulus to produce adaptation is critical to restore function or improve motor and cognitive performance. Although each patient case is unique, the most likely answer is that both strategies will be employed. The challenge for rehabilitation teams is to sort out how much of a patient’s dysfunction arises from neurodegeneration, which necessitates compensation, and how much occurs from inactivity and system deconditioning, in which case system capacity can be restored to some extent. Conclusion: Rehabilitation professionals must choose therapeutic interventions based on whethercompensation or restoration is the goal.