Multiple Sclerosis: Rehabilitation Programs
When you have multiple sclerosis (MS), you may have certain physical and cognitive challenges. Rehabilitation—including physical therapy, occupational therapy, speech therapy, and cognitive retraining—may help reduce these disabilities.
- Physical therapy may improve your ability to perform daily activities and make you feel better.
- Occupational therapy may help you perform daily activities more easily—especially those involving your hands and arms, such as grooming, dressing, and eating. Assistive devices may be used to help you perform daily tasks.
- Speech therapy may improve your communication skills if MS symptoms are making speaking difficult.
- Cognitive retraining may help improve cognitive impairment caused by MS.
Your personal physical therapy program to restore and maintain mobility will depend on the severity and duration of your MS symptoms. You may need physical therapy only occasionally as symptoms flare. Or you may need it daily to reduce constant symptoms.
Your ability to perform the exercises will help your therapist know which exercises to prescribe. Most therapy can be done at home either alone or with an assistant after an initial training program at the therapist's office. Occasional office visits will be needed to help the therapist monitor your progress. All exercise programs should allow you time to "cool off" in between exercises, since heat can make MS symptoms worse. The most common types of physical therapy include:
- Exercises to stretch your muscles and increase your range of motion.
- Exercises to strengthen and develop upper arm muscles and upper body control.
- Gentle aerobic exercise, such as walking or riding a stationary bike.
- Aquatic (water) exercises.
- Instructions on how to fall safely if you have problems with balance.
Occupational therapy usually first includes an assessment to find out your needs and to see whether assistive devices are needed. The occupational therapist will provide you with:
- Help in getting appropriate assistive devices, including those that help you stay mobile.
- Training in walking and use of assistive devices, including use and care of a wheelchair.
- Instructions on how to transfer from a wheelchair to a bed, bathtub, or automobile if needed.
MS can cause problems in speech, speech patterns, and with swallowing when lesions form in the brain and interfere with message flow in the nerves. Speech therapy may help you:
- Reduce long pauses in your sentences or within words.
- Reduce slurring of words, which may result from weakening or uncoordinated muscles of the tongue, lips, cheeks, and mouth.
- Reduce nasal sound that may occur when facial muscles become too relaxed.
- Help improve speech patterns or rhythms, enunciation of words, and general oral communication.
- Help you speak with other means—such as alphabet cards, a cell phone, or tapes—if you are no longer able to speak.
- Help you to recognize swallowing problems and change the types of food you eat if swallowing becomes difficult.
Cognitive retraining is a fairly new area of MS rehab. Its goal is to help you improve cognitive function if you have any cognitive impairment, such as difficulty remembering, caused by MS. Cognitive retraining may help you:
- Evaluate and identify any cognitive impairment related to MS.
- Retrain yourself to rely on other methods for remembering and staying organized, such as with a computer, cell phone, notebook, or filing system.
- Help you identify and get help for associated depression, anxiety, stress and fatigue, all of which may reduce your cognitive ability.
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