What to expect

Send your MS type, approximate EDSS if known, current disease-modifying treatment, relapses in the last year, walking distance, and your main difficulties. A physician replies within 48 hours with goals, block length and — importantly — whether now is the right time.

If you are mid-relapse the reply will usually suggest waiting. That is not a deferral for our convenience; a block during a relapse tends to achieve less than the same block later.

Assessment of walking, balance, strength, spasticity, fatigue, heat sensitivity, bladder symptoms and cognition. Exercise intensity is established from testing rather than estimated.

Expect the first week to feel lighter than you travelled for. Starting at the intensity you imagine you should manage is the most common way an MS block goes wrong.

Aerobic and strength training at prescribed intensity, aquatic sessions, gait and balance work, spasticity management. Intensity is adjusted continuously against fatigue rather than fixed at the start.

A bad day is not a failure and does not mean the block is not working. It is expected and it is planned for; what matters is the trend across weeks.

Re-measurement against the baseline, a home programme built to be sustainable at your energy level rather than at your best day, and energy conservation strategies written down.

You leave with a discharge document for your neurologist and a realistic interval for coming back.