If you or someone you love is struggling with multiple sclerosis (MS), one thing is for certain: you have more questions than answers.
- What causes the immune response that destroys myelin and damages nerves?
- When will your next relapse be?
- What triggers a relapse?
- What nerves will be affected, and what symptoms will you experience?
- How will your body respond to treatments?
- How will your disease progress, and what limitations can you expect in the future?
No one fully understands MS; the causes of the disease and its progression remain the subject of considerable research. No one can predict the impact MS will have on your body, your future, or your life.
Amidst all this swirling uncertainty, it becomes critically important for patients to hold tightly to truths that are firm and reliable. One truth that is especially important for MS patients to cling to is this: restorative rehabilitation strategies will improve your quality of life. To be clear, rehabilitation will not cure MS. It will not slow the progression of the disease, nor will it necessarily restore your abilities to where they were prior to relapse. What rehabilitation will do, however, is help you be as active, safe, and as physically and mentally engaged with your life as you possibly can be at your stage of MS.
MS patients experience a number of benefits from regular, strategic rehabilitation, including the following:
- Their good health beyond MS symptoms is preserved.
- They experience lower levels of fatigue.
- Their strength, balance, and flexibility are improved.
- They are better prepared to meet future challenges.
- They receive assistance with adaptive tools.
- They learn new skills to adapt to their changing abilities.
- They have a more positive mental outlook.
- They are more able to stay actively involved in their own care.
- They have a greater ability to function at home, at work, and at play.
MS is a complicated disease that touches every aspect of the patient’s life, so it should be no surprise that effective rehabilitation takes several forms. Any rehabilitation program should include components of all the strategies, depending upon symptoms and the stage of the disease.
The role of physical therapy is to attend to the body’s ability to function and move appropriately; the goal is to promote independence and safety. Physical therapists have tools to help MS with a variety of issues that include obvious challenges such as mobility, gait, and balance, as well as less visible issues such as bowel and bladder dysfunction. Without physical therapy, the symptoms of MS get worse.
Physical therapy plays a role at every stage of MS:
Physical therapists make a baseline assessment of the patient’s abilities and offer strategies to help with fatigue. They can also address subtle balance and gait issues that may be present.
Following a Relapse
Physical therapy following a relapse helps return the patient to their baseline functioning.
As MS progresses, physical therapy serves to address declining abilities proactively. Patients also receive help with adaptive tools such as canes or walkers.
Patients with advanced MS are rarely ambulatory, but physical therapy continues to be important for maintaining healthy seated positions and improving strength in upper extremities as well as assistance with breathing, speech, spasticity, and bowel and bladder relief. Non-ambulatory MS patients also need help with performing weight-bearing exercises on long bones even when they are not in use.
Occupational therapists help MS patients get through each day. They help their patients navigate their homes, cars, and workplaces with strategies and adaptive tools to simplify tasks and conserve energy. Again, the goal is to help MS patients remain independent, productive, and safe. While physical therapy focuses on the body, occupational therapy focuses on tasks. Examples of typical MS modifications include devices such as grab bars to help patients remain upright in the shower; cleaning tools that are easier to manage and hold; behavior modifications for bathing, toileting, and dressing; and assistance with driving a car using hand controls.
Attention, focus, memory, and problem-solving skills all take a significant hit from MS; most MS patients struggle to some degree with one or more of these issues. Professionals such as neuropsychologists and some occupational therapists work with MS patients to evaluate their cognitive health and suggest strategies for maintaining or even improving brain function. These strategies fall into two basic categories:
This is basically physical therapy for the brain. Specialists use tools like puzzles, games, and computer programs to improve functions like memory and attention.
Think of this as occupational therapy for the brain. Compensatory interventions, also called workarounds, are intended to help MS patients function successfully despite their deficits. Examples include calendars, alarms, filing systems, notes, etc.
Speech and Language Therapy
MS can cause patients to lose muscle control in their lips, tongue, vocal cords, diaphragm, and soft palate, resulting in a range of speech difficulties that includes challenges such as a lack of precise articulation, the inability to maintain a conversation, or the inability to control volume, tempo, or voice quality effectively. Swallowing can also be affected. Speech/language pathologists have access to therapies that can help MS patients improve their breath support, safely swallow, and improve their communication. They also have access to tools to assist MS patients with significant speech difficulties such as computer-assisted communications devices or voice amplifiers.
Meaningful work is key to maintaining good mental health. Assistive technologies and advanced physical and occupational therapies make it possible for many MS patients to continue in their chosen vocations. Each state in the US has a vocational rehabilitation program for residents with MS that has the goal of helping MS patients remain employed as long as possible. Vocational rehabilitation includes a combination of services such as job training, job coaching, assistive technology, and job placement services, all designed to assist MS patients in finding and keeping meaningful employment that accommodates their changing physical needs.
The Care You Need
MS is a lifelong disease. The caregivers at 24 Hour Home Care are specially trained to assist with many of the rehabilitation needs of MS patients. We are an invaluable resource for patients who wish to remain independent but, at the same time, need extra assistance. Contact us to discuss how we can help with your MS care and rehabilitation program.