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Rehabilitation and Multiple Sclerosis

Posted on May 20, 2021
Medically reviewed by
Amit M. Shelat, D.O.
Article written by
Ryan Chiu, M.D.

Multiple sclerosis (MS) can be a frightening and frustrating diagnosis, and its symptoms can have a negative impact on your overall well-being and quality of life. A large part of MS care and recovery involves working with a well-rounded rehabilitation team of health care professionals, so you can maintain and restore function as well as possible.

MS symptoms are due to lesions that develop in the central nervous system, which includes the brain and spinal cord. These lesions damage nerve cells and their protective coating (called myelin). MS affects parts of the central nervous system that control movement and your ability to speak, see, or feel touch. As a result, many people living with MS often have several symptoms at once, such as:

  • Muscle weakness
  • Numbness
  • Tingling
  • Vision loss
  • Cognitive difficulties

This article will help you better understand the different outpatient (occurring outside of the hospital) rehabilitation services you may encounter.

Physical Therapy

Working with physical therapists (PTs) can help you gradually regain your mobility, and there is strong evidence supporting their role in improving the lives of people with MS. PTs may work with physiatrists, doctors who specialize in physical medicine or physical rehabilitation related to the brain, nerves, muscles, or bones. Physical therapists and physiatrists will take a well-rounded approach toward improving your functioning, independence, and quality of life.

Strategies PTs use often include gradual exercise routines to help you move around and use your arms and legs more easily. PTs may also recommend and give you information about assistive devices that can help you walk around, regain strength, and maintain balance to avoid falling or harming yourself.

Exercise Therapy

Physical activity has been shown to improve strength and help people living with MS recover from impairment. When working with a PT, exercise therapy is typically done gradually over a longer period of time (sometimes one to two sessions per week for 12 weeks). These programs may at first help you to move your arms and legs with and against gravity. As you progress, these programs could include weights.

Exercise therapy helps increase muscle strength, which is a key component to performing everyday activities and has been shown to reduce fatigue.

Exercise also prevents deconditioning, which is when muscles become weak from lack of use. It can also prevent contractures — when arms or legs become fixed in a certain position from lack of movement in another direction.

Pelvic Floor Exercises

Up to 80 percent of people with MS also report losing control of their bladder in some way. Bladder-control issues are often due to weakness of the pelvic floor muscles that surround the bladder and control the release of urine. PTs may recommend certain exercises that will strengthen these muscles and hopefully improve your bladder control.

Wearables and Assistive Devices

Assistive devices include wearable items, such as braces and orthotics, as well as devices that help maintain balance, such as crutches, wheelchairs, scooters, canes, and walkers.

Braces are worn when an arm or leg is deformed, contracted, or otherwise unable to move in a certain direction. For example, if MS impaired your ability to bend or straighten your knee, a knee brace could help you do things such as driving.

Read more about physical therapy and MS here.

Occupational Therapy

Occupational therapists (OTs) are rehabilitation specialists, though they are often confused with PTs. Whereas PTs focus on physical functioning, OTs focus more on helping you adapt into performing activities of daily living, self-care, and leisure. OTs may work with you to adjust your home environment to be more accessible based on your MS symptoms. They may teach you energy-conservation techniques to help you do work that involves more effort.

Accessibility

OTs play a huge role in making your home easier to get around. Increasing the accessibility of your environment might mean rearranging objects so that you are less likely to hurt yourself while doing daily activities. Additionally, OTs may recommend having different tools installed in your home, like shower bars, to help keep you safe and independent.

Energy Conservation

OTs can also help you work on adaptive energy-conservation techniques that help prevent exhaustion and fatigue. Examples include making schedules, reducing the number of tasks you do on any given day, and avoiding heat.

Vocational Rehabilitation

Some MS rehabilitation programs and interventions also involve vocational rehabilitation, in which specialists help you get back to work or find new jobs.

Learn more about career options for those with MS.

Speech-Language Pathology

MS commonly affects a person’s ability to speak. Many MyMSTeam members frequently report slurred speech and difficulty in finding words. MS might also prevent you from swallowing properly, as many of the same muscles that help with speaking also help with swallowing.

Speech therapy is done by speech-language pathologists and focuses on pronunciation as well as swallowing. This type of rehabilitation can be especially important because food and liquids can otherwise get into the lungs and cause choking or other serious problems, such as infections.

Cognitive and Mental Health Professionals

Anxiety, depression, and other mental health issues are much more common among people with MS than the general population. If you show signs of mood problems or cognitive (thinking) impairment, your neurologist may have you follow up with a therapist or neuropsychologist.

Working with these specialists may help improve your cognitive functions, such as your ability to:

  • Think
  • Learn
  • Remember things
  • Make decisions
  • Solve problems

Improving cognitive function can help you perform tasks in your daily life that involve more mental energy.

Benefits of Rehabilitation

Regardless of the course of your MS — whether your symptoms only come during flares (relapsing-remitting MS) or are always present (progressive MS) — rehabilitation can help you maintain your independence as much as possible and maximize your overall health and wellness.

All of these providers can also teach family members and caregivers how to work with you, so that you and your loved ones can go on to live your best possible lives.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 167,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you undergoing rehabilitation for MS? What’s been successful or less successful? Share your experience in the comments below, or start a conversation by posting on MyMSTeam.

Amit M. Shelat, D.O. is a fellow of the American Academy of Neurology and the American College of Physicians. Review provided by VeriMed Healthcare Network. Learn more about him here.
Ryan Chiu, M.D. obtained his medical degree from the University of Illinois College of Medicine in 2021. Learn more about him here.

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