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When you have
multiple sclerosis (MS), you may have certain physical
cognitive challenges. Rehabilitation—including
physical therapy, occupational therapy, speech therapy, and cognitive
retraining—may help reduce these disabilities.
rehabilitation (rehab) program will depend upon your specific needs based on the
type of MS that you have and how it has impacted your daily living. You do
not need to be severely disabled to enjoy the benefits of rehab. Your
rehab may include a combination of the following therapies or only
one, depending on your personal needs.
Relapsing-remitting MS, the most common type of MS,
may cause a variety of physical problems at different times. Your physical
therapy program will reflect the kinds of exercises you are able to do at any
Physical therapy will usually consist of alternating
exercise with periods of rest for the best results. Depending on your ability,
exercise usually includes gentle aerobic exercise (such as walking) and
aquatics—exercising in water—which reduces the effects that gravity has on your
muscles and joints. You should be able to obtain a greater
range of motion in the water.
Your need for occupational
therapy will depend on your personal symptoms and disability from MS.
Occupational therapy may help with activities such as getting dressed, brushing
your teeth, grooming, eating, cooking, cleaning your house, or any other task
that you are having difficulty completing.
occupational therapist will assess your living
environment to see whether you need
assistive devices such as a cane to help you walk,
hooks to help you button your clothes, an electric toothbrush, or a
The occupational therapist may help the physical
therapist recommend strengthening and stretching exercises and other activities
that will help you the most.
Speech therapy may be part of your
rehab if weak facial muscles or lesions (injured tissue from
demyelination) in the brain have affected your ability
to talk or swallow.
Your normal speech rhythm may be interrupted
by long pauses between words or syllables. You may also begin to slur your
words or have a nasal tone when you speak. Speech therapy may help strengthen
the muscles in your tongue, cheeks, mouth, and lips, which may reduce these
If you have difficulty swallowing, a speech therapist
may recommend strengthening exercises and help you identify foods that are
easier to swallow.
Many people with MS develop
some kind of cognitive impairment—usually slowed thinking, reasoning,
remembering, or concentrating—from
demyelination and the interruption to the flow of
messages to and from the brain. But only a small number of people have
resulting cognitive problems severe enough to interfere with daily activities.
For these people, cognitive retraining may help reduce cognitive
Cognitive retraining offers ways to reduce the effects
of cognitive disability. For instance, you may become better organized by
retraining yourself to rely on a notebook, computer, cell phone, or
filing system to help you store and recall information.
Rehabilitation (rehab) for MS includes physical therapy,
speech therapy, occupational therapy, and cognitive retraining. Rehab
needs vary depending on the type of MS you have. Your program will be tailored
to your specific needs.
MS rehab may be effective at reducing
disability caused by MS. It includes physical, occupational, and speech therapy
along with cognitive retraining if needed. MS affects people differently,
depending on the location of lesions in the central nervous system. You may
only need rehab when symptoms occasionally flare up, or you may need
continual rehab services if your symptoms are constant.
Continue to Why?
Rehabilitation (rehab) may help you live a more productive life, especially if
your symptoms are constant or severe. Physical and occupational therapies may
help keep you mobile, speech therapy may help you continue to communicate well,
and cognitive retraining may help with memory and organization. All types of
rehab will be tailored to fit your specific needs.
primary goal of physical therapy is to help prevent physical complications that
may occur with MS such as
contractures (abnormal shortening of muscles) or
pressure sores (bedsores) if you are immobile.
I don't need rehab if my symptoms are not
You do not need to be severely disabled to
benefit from rehab. It may help you restore and maintain your body's
ability to move or function, make you feel better, reduce your pain, and
improve your ability to perform daily activities. It is important to get
guidance from a health professional trained in rehab for MS, though,
in order to derive the maximum benefits possible.
Continue to How?
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:
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:
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:
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:
Mobility problems caused by MS are
While MS may cause problems with mobility,
there are many ways to reduce how it affects you. Gentle aerobic or aquatic
exercises may restore and maintain your ability to move muscles. Be sure to
cool off as you exercise, since heat may make your symptoms worse. Assistive
devices such as canes, walkers, or wheelchairs are also available if weakness
affects your walking. Gentle exercise may also reduce pain and stiffness
associated with MS attacks.
I don't need rehab since my symptoms
from MS only flare up occasionally.
Even if you have only occasional flare-ups,
rehab may help you and your family understand your condition. It also
may help you keep your muscles stretched and toned to reduce the impact of
symptom flare-ups. Rehab may make you aware of future symptoms to
watch for, such as difficulty remembering, speaking, or swallowing. Early
treatment of MS symptoms may reduce their impact on your life.
Continue to Where?
For more information about rehabilitation and MS, talk to:
Return to topic:
February 15, 2012
Adam Husney, MD - Family Medicine & Anne C. Poinier, MD - Internal Medicine & Barrie J. Hurwitz, MD - Neurology
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