Understanding and Managing Primary Progressive MS (PPMS)

What is Primary Progressive MS (PPMS)?

Primary Progressive Multiple Sclerosis (PPMS) is a less common but more severe form of MS, affecting around 10-15% of those diagnosed. Unlike Relapsing-Remitting MS (RRMS), where symptoms come and go in episodes, PPMS is characterised by a gradual worsening of symptoms over time without distinct periods of relapse and remission.

For those living with PPMS, symptoms tend to appear steadily and progressively from the onset, rather than in sudden attacks. Many people with PPMS find that mobility issues are among the first and most significant challenges, as the condition primarily affects the spinal cord rather than the brain. This often results in difficulties with walking, balance, muscle weakness, and coordination. While some individuals with PPMS may experience mild cognitive or sensory issues, the most significant impact is usually on physical function.
Another key difference between PPMS and other types of MS is how it responds to treatment. Many disease-modifying therapies (DMTs) used for RRMS are not as effective for PPMS, making physical therapy, symptom management, and lifestyle interventions even more crucial in slowing progression and maintaining quality of life.

Although PPMS presents its own unique challenges, the good news is that with the right therapies, exercises, and support networks, people with PPMS can take an active role in managing their condition. At the Samson Centre, we offer a comprehensive range of therapies, physiotherapy programmes, and exercise classes designed to help individuals with PPMS stay as mobile, active, and independent as possible.

How the Samson Centre Supports Individuals with PPMS
Oxygen Therapy for PPMS Symptom Relief
One of the key therapies available for people with PPMS at the Samson Centre is oxygen therapy. This treatment involves breathing in pure oxygen in a pressurised chamber, which allows the body to absorb higher levels of oxygen than normal. For those with PPMS, oxygen therapy can offer several potential benefits, including:
– Reduced inflammation, which may help to slow disease progression
– Increased energy levels, particularly for those experiencing severe fatigue
– Improved circulation and tissue repair, which can aid mobility and muscle function

Many of our members with PPMS report that regular oxygen therapy helps them feel more energised, experience fewer aches and pains, and maintain better mobility for longer. Our oxygen therapy suite includes both individual oxygen chambers and a multi-person chamber, ensuring a comfortable and accessible experience for all.

Exercise and Physiotherapy for Mobility Preservation in PPMS
One of the most challenging aspects of PPMS is the gradual loss of mobility that occurs as the condition progresses. While PPMS may not have sudden relapses like RRMS, the steady decline in function makes regular exercise and physiotherapy absolutely essential. At the Samson Centre, we place a strong emphasis on movement-based therapy, with programmes designed to:
– Strengthen muscles and prevent muscle atrophy
– Improve balance and coordination
– Enhance flexibility and range of motion
– Slow down the loss of mobility and help individuals retain independence for as long as possible

For individuals with PPMS, tailored exercise programmes can make a significant difference in maintaining functional ability. Some of the most beneficial classes we offer include:

1. Low-Impact and Seated Exercise Classes
Because mobility issues are often a key concern in PPMS, our physiotherapy-led classes focus on low-impact movement and gentle strengthening exercises. These include:
– Seated Tai Chi, which combines gentle movements with breathing techniques to improve balance and reduce stress
– Stretching classes, designed to maintain flexibility, circulation, and muscle function
– Seated Pilates, which helps to build core strength and stability

For those who cannot attend in person, we also offer many of these classes via Zoom, ensuring that individuals with limited mobility or transport difficulties can still benefit from structured exercise sessions.

2. Balance and Strength Training for Fall Prevention
One of the biggest concerns for individuals with PPMS is fall prevention, as balance and coordination become increasingly affected over time. At the Samson Centre, we offer:
– Standing Balance Classes, designed for those at risk of falls, helping to improve leg strength, coordination, and reaction times

–Standing Pilates and Balance Workouts, which integrate leg strengthening, flexibility, and controlled movement to support walking and stability

Neurofit Circuits, which focus on building strength and endurance to improve overall function
By consistently engaging in these exercises, individuals with PPMS can reduce the risk of falls, maintain functional mobility, and continue carrying out everyday activities with confidence.

3. Seated HIIT and Group Circuit Classes for Cardiovascular Fitness
It’s common for individuals with PPMS to experience reduced stamina and cardiovascular endurance, particularly as mobility declines. However, staying active is crucial not just for physical health, but also for mental well-being. That’s why we offer:
–Seated HIIT (High-Intensity Interval Training) Classes, which provide an effective cardiovascular workout without requiring high-impact movement
–Group Circuit Classes, where individuals receive support in standing while engaging in structured exercise routines
These classes help to increase heart rate, boost circulation, and build overall endurance, all of which can improve energy levels and reduce fatigue.

Cognitive and Hand Function Support for PPMS
While PPMS primarily affects mobility, it can also impact cognitive function, memory, and fine motor skills. At the Samson Centre, we recognise the importance of maintaining brain health and hand mobility, which is why we offer dedicated cognitive and dexterity support classes.

1. Brainfit: Keeping the Mind Sharp
Cognitive challenges, such as memory difficulties, brain fog, and slower processing speeds, are common in PPMS. Our Brainfit classes are specifically designed to help individuals:
– Engage in mental exercises that challenge problem-solving skills
– Improve focus and concentration through structured cognitive tasks
– Enhance memory retention through interactive activities

Brainfit is particularly beneficial for maintaining cognitive sharpness and slowing down cognitive decline, offering a social and stimulating way to keep the mind engaged.

2. Hand Mobility and Dexterity Training
As PPMS progresses, some individuals experience weakness in their hands, fingers, and grip strength, making everyday tasks like holding a cup, writing, or using utensils more challenging. Our Hand Group provides specialised exercises to:
–Strengthen grip and finger mobility
-Improve dexterity and hand-eye coordination
–Help individuals retain the ability to perform fine motor tasks independently

For those who need additional support, we recommend attending with a carer or support partner to maximise the benefits of the sessions.

Emotional and Social Well-being: Finding Community with PPMS
Living with a progressive condition like PPMS can be emotionally challenging, and many people experience feelings of isolation, frustration, and anxiety. That’s why the Samson Centre provides more than just physical therapies—we foster a supportive and welcoming community where individuals can:
– Connect with others facing similar challenges
– Share experiences and coping strategies
– Build friendships and social support networks

Many of our classes, including Brainfit, Tai Chi, and social meet-ups, offer opportunities to engage with others in a positive and encouraging environment. Whether in-person or online, these connections can provide a sense of belonging and emotional support that is invaluable when navigating the challenges of PPMS.

Living Well with PPMS: The Samson Centre is Here to Support You
While PPMS is a progressive condition, there are many ways to slow down its impact, maintain function, and improve quality of life. At the Samson Centre, we provide targeted therapies, physiotherapy programmes, and exercise classes that empower individuals with PPMS to stay active, independent, and socially connected for as long as possible.
📩 For personalised support and to learn more about how the Samson Centre can help, contact us at info@samsoncentre.org.uk

Further Resources for MS Support
National Multiple Sclerosis Society (NMSS): www.nationalmssociety.org
MS Trust: www.mstrust.org.uk
MS International Federation: www.msif.org