| Individuals with the diagnosis of multiple sclerosis require a range of rehabilitation services due to the chronic and often progressive nature of the disease. The frequency and duration of rehabilitation is contingent upon the increasing severity of the symptoms. Because this disease is chronic, individuals will require rehabilitation at regular intervals throughout their lives.
Occupational therapy addresses any difficulty with activities of daily living. Individuals learn strategies for dressing, bathing, and meal preparation that are geared toward their particular functional limitations. Because there is a large component of fatigue associated with this disease, individuals learn energy conservation techniques, and strategies to complete tasks during the portion of the day that their energy level is highest. Occupational therapists may order adaptive equipment to facilitate independence with activities of daily living (ADLs).
Physical therapy addresses mobility techniques. Therapists instruct individuals in strategies for bed mobility, transferring position, and walking. Individuals who can walk but whose balance is decreased learn to use a cane, a walker, or crutches to improve their gait pattern. Individuals may also be fitted with orthotic braces for the legs to help with muscular control. Therapists instruct individuals who are no longer ambulatory how to use a wheelchair, and may order a wheelchair to fit the needs of the individual. Wheelchairs may have supportive padding to support correct sitting posture, pressure relieving seat cushions to decrease the risk of pressure sores, and may be manually propelled or motorized. Individuals learn to shift their weight periodically while seated to relieve pressure through the buttocks and further prevent pressure sores.
Both physical and occupational therapy address decreased balance, strength, and range of motion. Individuals and their caregivers learn to stretch each joint to maintain adequate flexibility for walking, wheelchair propulsion, transferring, and self-care activities. Therapists teach individuals exercises to maintain strength in the arms, legs, and trunk, and how to perform weight-shifting exercises to aid in transferring and walking. As individuals with multiple sclerosis tire easily with activity and with warm temperatures, exercise repetitions should be kept low with frequent rest periods, and all exercise should be performed in a cool room.
Speech therapy may be required for improved eating, swallowing, and speech. Due to fatigue, individuals may benefit from eating several smaller meals, or eating their large meal at the time of day in which they have the highest energy level. Therapists instruct individuals to perform jaw, tongue, and lip exercises to facilitate chewing and communication. Different food and liquid consistencies may be recommended to assist in the swallowing reflex. Individuals also learn to achieve sucking control and saliva production. Because shallow respiration often occurs in individuals with this diagnosis, speech therapists may teach diaphragmatic breathing and better sitting posture. Individuals learn to speak with greater clarity through activities such as sustained vocal expressions.
Individuals may require a consultation with a rehabilitation nurse and/or nutritionist who specializes in multiple sclerosis treatment if bowel and bladder function are compromised. Individuals learn to manipulate their diet to allow for better control of urination and defecation. Individuals who are urine incontinent may learn to self-catheterize at regular intervals to manage incontinence.
Individuals may benefit from ongoing consultation with a psychologist or psychiatrist to cope with the loss of functional and physical abilities and with any depression that may occur. This may be particularly important for those individuals who require the assistance of a caregiver. Counseling can also help individuals focus on realistic therapy goals and to maintain motivation. Psychologists and psychiatrists may facilitate support groups in which individuals speak with others who are living with multiple sclerosis. |
Source: Medical Disability Advisor