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Rehabilitation Recommendations for Multiple Sclerosis

The National Clinical Advisory Board of the National Multiple Sclerosis (MS) Society developed a consensus statement concerning the role of rehabilitation in MS care. The document provides guidance to physicians, nurses, therapists, insurers, policy makers, as well as people with MS, concerning the optimal use of physical rehabilitation strategies in MS care.

The paper, which is called “Rehabilitation: Recommendations for Persons with Multiple Sclerosis,” is available online. This document is important to read and share with your healthcare providers because it can be used to guide treatment and demonstrate the importance of rehabilitation to your insurance company.

Your physician — usually your neurologist or a physiatrist (a specialist in physical medicine and rehabilitation) — functions as the rehabilitation team leader. As needs are identified (preferably as early in the disease as possible before crises have a chance to develop), the physician refers you to the appropriate specialist.

These early interventions, which introduce you to energy management strategies, an exercise regimen, and ways to feel and function at your best, help you to be an active partner in your own care. All of the following professionals work with you to ensure that your needs are met.

MS rehab team: Physical therapist

The physical therapist’s (PT’s) role is to evaluate and improve your strength, mobility, balance, and posture, and to recommend fatigue management strategies. PTs evaluate your abilities and then use this information, along with the information you provide about your needs and priorities, to develop a treatment plan.

The plan involves exercises to address your physical symptoms — fatigue, weakness, stiffness, impaired balance — as well as training in the use of the most appropriate mobility aids. In other words, they help you create a tool chest — and they’re the world’s best cheerleaders.

MS rehab team: Occupational therapist

An occupational therapist (OT) helps you maintain the everyday skills that are essential to your activities at home and at work. OTs are among the most creative people on earth — they know a tool or workaround for any activity you can imagine. OTs know all the helpful gadgets, from easy-to-hold cooking utensils to pre-tied elastic shoelaces that save you from having to tie your shoes when your fingers are numb or tingly.

When an OT works with you, he or she will help in four main areas:

  • Strength and coordination of your upper body

  • The use of assistive technology to enhance your independence and productivity at home and at work

  • Fatigue management, with strategies to conserve your energy, simplify and expedite tasks, and manage your stress

  • The use of compensatory strategies and tools to deal with any problems you may have with vision, thinking, or sensation

OTs can evaluate your home space and work space, and then recommend ways to make those environments work comfortably for you.

MS rehab team: Speech/language pathologist

Speech/language pathologists (S/LPs) evaluate and treat speech and swallowing problems that can be caused by impaired muscle control in the lips, tongue, soft palate, vocal cords, and diaphragm. So, the goals of treatment are to help you communicate effectively and to address any swallowing difficulties that may be affecting your health, comfort, and safety. Many S/LPs also evaluate and treat problems with memory, organization, and planning and problem-solving.

MS rehab team: Vocational rehabilitation counselor

Vocational rehab counselors (also referred to as employment or career counselors) help people determine their work options. For example, by using information from other members of the rehabilitation team about your physical, cognitive, and emotional challenges, the counselor can make recommendations about disclosure, job accommodations, additional skills training, and retraining for alternative careers. While some rehab counselors work privately, others work in rehabilitation facilities and in state vocational rehabilitation offices.

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