Mobility impairment is one of the top problems associated with multiple sclerosis (MS). Fifty-six percent of people diagnosed with MS reported a loss in motor function resulting in diminished quality of life. However, research in the area of mobility and motor control and their effects on people with MS is scarce.

Types of Motor Dysfunction

Both gross and fine motor skills depend on the function of the brain, neurons, muscles, and central nervous system.

The effects of MS (nerve demyelination, brain lesions) on these body systems cause signal disruption to the brain that results in motor dysfunction. MS symptoms can significantly impact the body’s motor function and the muscle control needed to perform activities of daily living.

Fine Motor Skills

A decrease in fine motor skills can occur at any stage of MS. Fine motor skills involve the hand muscles, and impairment can lead to problems with writing and the coordination needed to work with small objects.

Fine motor symptoms may include:

• Hand weakness
• Decreased dexterity
• Dystonia (uncontrolled muscle contractions)
• Numbness and muscle weakness
• Spasticity (tightness in muscles and joints)
• Problems with coordination and making small movements

Gross Motor Skills

Walking, balance, lifting the head, sitting, and physical activity all require the use of gross motor skills. These skills involve our large muscles (legs, neck, arms) and the ability to have a wide range of motion.

When nerve pathways are disturbed in certain areas of the body due to MS, you can lose motor control and function in your large muscles, which leads to a loss of mobility.

Gross motor symptoms may include:

• Loss of balance
• Pain from muscle spasms
• Trouble walking
• Problems moving arms and legs
• Tremors
• Slurred speech
• Weakness
• Fatigue
• Numbness or abnormal sensations in arms and legs
• Problems with vision and cognition

Planning Ahead

Losing mobility and motor function can have major consequences on your quality of life. As MS symptoms progress, your treatment plan and daily activities will need to be adjusted. Here are some areas of your life that may be affected by motor function:

• Driving and transportation
• Working
• Preparing meals
• Writing and using a keyboard
• Getting dressed
• Showering and bathing
• Living independently

Planning for changes in mobility can help decrease stress and anxiety when the time comes to make changes.

Strategies to Improve Motor Abilities

There are several ways to work on improving your motor skills and mobility to help retain areas of independence in your life. Strategies that have proven to strengthen motor function and control include:

• Occupational therapy
• Physical therapy
• Hand dexterity exercises
• Adaptive devices
• Exercise for overall well-being

Occupational Therapy

Occupational therapists can work with you to improve your upper body strength and fine motor skills, which will assist you in performing activities of daily living. They can also help you reduce fatigue by teaching you energy-saving techniques.

Additional strategies recommended by occupational therapists include:

• Praciticing safe transfer techniques
• Spreading tasks out over a period of time
• Sitting whenever possible
• Doing heavier chores when you have the most energy
• Sliding objects rather than lifting them
• Holding cups or glasses with two hands
• Dressing the weaker side first
• Getting dressed while sitting
• Avoiding hot water when bathing

Physical Therapy

Physical therapists are well trained in working with physical mobility impairments. They can help you with:

• Walking/gait training
• Specific exercises to increase muscle strength
• Coordination and balance
• Finding appropriate assistive devices
• Spasticity (stretching and range of motion exercises)
• Specific medications that help with mobility (Ampyra, Zanaflex, Lioresal, Botox)

A MyMSTeam member shared how physical therapy has helped her: “My physical therapist gave me strengthening exercises, which involve elastic bands. They work great. It seems to be helping my foot drop.”

Read more about physical therapy and MS.

Hand Dexterity Exercises

There are many ways to strengthen hand muscles and dexterity. Some popular exercises people can do to improve their fine motor skills include:

• Stacking pennies
• Stringing beads
• Playing with putty
• Rolling a pencil between the thumb and finger
• Picking up marbles one at a time
• Wringing out wet washcloths
• Picking up toothpicks with tweezers
• Drawing or painting
• Practicing buttoning a shirt

A MyMSTeam member shared an exercise that helps her hand dexterity: “I make beaded bracelets. It helps with manual dexterity, and it soothes me.”

Another team member added, “I have been getting back into card flourishing tricks to exercise my dexterity.”

Adaptive Devices

Many adaptive devices can help you with both fine motor and gross motor skills to make daily living easier. These devices can include:

• Writing aids (pen grip or fatter pens)
• Keyboard modifications
• Reaching aids
• Button hooks
• Zipper pulls
• Velcro shoes
• Shoe horns
• Utensils with oversized handles
• Nonskid placemats and bathmats
• Electric toothbrush and razor
• Hands-free hairdryer
• Rocking T knives
• Seat for the shower

Keeping Fit

One of the best ways to improve mobility and dexterity is to stay physically active. Work with your health care team to find an exercise routine that keeps your large muscles and hand muscles active, such as yoga or tai chi.

Talk With Others Who Understand

MyMSTeam is the social network for people living with MS and their loved ones. By joining, you gain a community of more than 167,000 people who come together to share stories and advice about life with MS.

How do you work to improve your motor skills? Do you have any strategies that have helped you? Share your experience in the comments below or on MyMSTeam. Your story may help others figure out how to improve their mobility.