The Benefits of Restorative Rehabilitation

From the WebMD Archives

Restorative rehabilitation has many benefits if you have multiple sclerosis.

Rehab can help keep you as active, able, safe, and engaged as you can be at your stage of MS. It’s especially important after a flare-up to get back as much ability as you can.

Restorative rehabilitation doesn’t stop the progression of MS, but it can greatly improve your quality of life, says Rosalind Kalb, PhD, vice president of the professional resource center at the National Multiple Sclerosis Society.

It can help you:

  • Maintain general health
  • Improve strength, flexibility, and balance
  • Train for problems that may come down the road
  • Help incorporate things like canes and walkers
  • Learn new skills
  • Boost your mental outlook

MS is unpredictable and affects everyone differently. So it’s important to have a rehab program designed for you. A rehab team will look for and identify problems, set goals, and come up with treatments.

“With MS, you always want to intervene as early as possible,” says Francois Bethoux, MD, at the Cleveland Clinic. He says good timing can really make a difference in your ability and quality of life.

Restorative rehabilitation includes:

  • Physical therapy
  • Occupational therapy
  • Speech/language pathology
  • Cognitive therapy
  • Counseling

Physical Therapy

MS causes muscle weakness, stiffness, numbness, and fatigue. Because these can make walking and exercise tough, people with MS are often inactive, which can make the symptoms worse. Physical therapy can bring about big improvements.

Targeted exercise does the most good, says Herb Karpatkin, DSc. He’s a physical therapist who specializes in MS.

“It’s not just exercise. It’s the right exercise for the right condition,” Karpatkin says.

For example, if you have foot drop because of your MS, you need to do different exercises than someone who needs to work only on stamina walking.

Your balance, endurance, strength, and flexibility can all get better with therapy. It can help even if you’re in a wheelchair.

Because fatigue tends to be an issue, Karpatkin recommends you break up your exercise. For example, instead of 20 minutes of walking, walk for 5 minutes and rest, four times.

You’re more likely to be heat sensitive if you have MS. Cooling garments can help. One study Karpatkin did showed a cooling vest allowed the same person to walk an average of an extra 100 feet during a 6-minute walk.

It’s also important that you are assessed both when you’re tired and when you’re not. That way, your therapists get a true picture of what type of help will work best.

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Occupational Therapy

This can help you maintain your everyday skills. Your therapist will see what challenges you. She can then:

  • Help improve upper body strength and coordination
  • Offer devices that can assist you, like a grab bar for your shower or special kitchen or cleaning tools
  • Show you how to make your home and workplace more comfortable

If you’ve lost some ability because of a flare-up, she can help you with skills like:

  • Cooking
  • Cleaning
  • Dressing
  • Bathing
  • Going to the bathroom

If needed, your occupational therapists can also:

  • Teach you how to use a walker or cane
  • Help you learn how to drive a car using hand controls

Kalb says they can also help you figure out when you have the most energy and focus, so you can plan your day in a way that makes you the most productive.

Cognitive Therapy

This can offer strategies for trouble with attention, focus, memory, and problem solving that can happen with MS. About half of MS patients have some of these problems. To help you focus at work, for example, you might need to move your desk so it doesn’t face a busy hallway.

To improve memory, you can learn tools to help your remember where you put things or keep you from forgetting things on your to-do-list. There are also computer exercises you can do to work your short-term memory, processing speed, and focus.

Speech/Language Therapy

A speech/language therapist can help if you’re having trouble speaking or swallowing. Less muscle control in the lips, tongue, soft palate, vocal cords, and diaphragm can cause problems with speaking and swallowing. As many as 40% of people with MS have speech problems.

A speech/language therapist can teach you exercises to help you relax and improve breath support. You also may need something to amplify your voice or a computer-assisted communications device.

Counseling

This is an important part of restorative therapy, not only for someone with MS, but for their family members, too. Many times finding an MS Support Group in your area can serve as a terrific support system. Contact the National MS Society to find a local chapter.

“There’s a huge emotional component,” Kalb says. “Counseling really helps with the feeling of loss and the fear of change.”

If you have MS, restorative rehab is an important way you can stay as active and productive as you can be. Talk with your medical team to learn what can help you.

WebMD Feature Reviewed by Richard Senelick, MD on January 31, 2017

Sources

SOURCES:

Francois Bethoux, MD, Cleveland Clinic.

Herb Karpatkin, PT, DSc, assistant professor, Hunter College, New York.

Rosalind Kalb, vice president, professional resource center, National Multiple Sclerosis Society.

Cleveland Clinic: “Occupational Therapy and Multiple Sclerosis.”

National Multiple Sclerosis Society: “A Focus on Rehabilitation,” “Speech and Swallowing.”

Annals of Indian Academy of Neurology: "Rehabilitation challenges in multiple sclerosis."

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