**4. Why was judo selected for rehabilitation in MS?**

Judo is a sport that develops all motor skills, that is, speed, strength, endurance and coordination. In addition, it promotes proprioception, as well as increases mobility in the joints and improves muscle stretching. The practice consists of making the opponent loose his or her balance while, at the same time, trying to control one's body posture in different planes. It is widely believed that

### *Role of Physiotherapy and Practice of Judo as an Alternative Method of Treatment in Multiple… DOI: http://dx.doi.org/10.5772/intechopen.95501*

the main determinant of success in judo is the efficiency and effectiveness of the postural control system. Therefore, when performing different exercises, techniques (*nage - komi*) as well as free practice (*randori*) the participant learns to feel the body movements and the position of the opponent (*uke*) and use unstable and dynamic situations on his or her favor. Constant stimulation of mechanoreceptors and proprioceptors and the liberation of adequate tension of stabilizing muscles within the trunk occurs constantly in the participant's body. A correct correlation between the central nervous system and the locomotor system (musculoskeletal system) is very important. In addition, judo is trained barefoot. The feet have the control over the transmission of information received both from the outside (position on the ground) and from the inside (adopted position) [15, 16]. Superficial mechanoreceptors located on the plantar side of the foot provide the CNS with information on the position of the body in relation to the vertical reference, based on gravitational forces, load-bearing surface reaction forces and shear forces, which plays an important role in maintaining a stable vertical position [17, 18].

Making unexpected moves imposed by the opponents can have a beneficial effect on improving the movement coordination of judokas in unexpected situations. The training enables them to develop they sensorimotor adaptation that also influences the control of body posture in other situations. During the judo practice, the central nervous system − thanks to available sensory information as well as biomechanical constraints − controls the position of the center of gravity of the body in relation to the feet and creates posture patterns that allows to maintain balance in a given position. Improving postural control as a result of practicing judo seems to be a consequence of improving motor coordination (postural strategy), primarily based on somatosensory information received from one's body.

It is worth paying attention to learning falling techniques in the context of falling to the ground in a safely way. Maintaining control prevents injuries and reduces the discomfort during the fall. A fall is an unintended change in the body position, which consists of losing the balance when walking or performing other activities. As a result of the fall, a person unexpectedly finds oneself on the ground or other low-lying surface. The probability of injury to various tissues increases at the moment when the speed of the person who falls rapidly drops to zero, as a consequence of the collision with the ground. From the biomechanical point of view, a fall can be broken into four phases. **The first phase** of adaptation to the repositioning of the body occurs unconsciously. Reaction that occur in the upper part of the trunk create increased muscle tension. **In the second phase**, still in an unconscious way, vestibular system reacts stimulating the lower kinetic chain. **The third phase** occurs consciously and aims to protect the spine from injury. The person who falls bends the body, with the simultaneous reduction of cervical and lumbar lordosis and rounding of the back. **The fourth phase** consists of a rapid energy dissipation and a reduction in the reaction force of the ground by hitting the outer edge of the upper limb against the mat (**Figure 1**) [20].

Judo is among sports commonly practiced by people with intellectual and motor disabilities. It is one of the disciplines included in the Paralympic Games. This sport is practiced, among others, by: blind or visually impaired people, people with impaired hearing, Down's Syndrome and with Cerebral Palsy [18, 21–23]. Judo elements were also used in the physiotherapy of patients after stroke [24]. The positive effects of the alternative methods of rehabilitation (such as tai-chi, kickboxing and yoga) among MS patients, as well as the many benefits of judo and its high therapeutic effectiveness demonstrated in groups with disabilities was one of the reasons why practice of judo by MS patients was considered.

**Figure 1.** *Learning* ukemi *[19].*
