Occupational Therapy

Multiple sclerosis (MS) is a progressive disease that is characterized by lesions occurring in the white matter of the brain and spinal cord. These lesions disrupt the flow of information within the brain, and between the brain and body.

Around 2.3 million people have MS worldwide. In the U.S., about 135 out of every 10,000 people have MS, with nearly 200 new patients being diagnosed every week.

MS patients experience symptoms such as muscle weakness, paralysis, spasticity (muscle tightness and resistance to movement), fatigue, psychological problems, and impairments of cognition, vision, speech, swallowing, bowel, and bladder functions. These limit their social activities, and their ability to perform daily tasks at home and work.

Occupational therapy for MS patients

Occupational therapy helps MS patients manage symptoms so that they can perform their daily tasks more efficiently. The goal is to help patients maintain everyday skills needed for independent living and productivity at home and work. MS patients learn how to conserve energy, manage their time, and move efficiently, with or without assistive devices.

How occupational therapy can help

An occupational therapist will work with an MS patient to identify areas of struggle and help find ways to overcome difficulties.

An occupational therapist can train the patient in:

  • Fall prevention
  • Energy conservation
  • Motor exercises
  • Upper-body strengthening and stretching
  • Stress management
  • Medication management
  • Money management
  • Activities of daily living
  • Getting back into the community
  • Vocational rehabilitation
  • Time management
  • Organization skills
  • Clutter management
  • Driving evaluation and rehabilitation
  • Use of adaptive devices and durable medical equipment
  • Safety

Additional information

To help MS patients, an occupational therapist can:

  • Suggest ways to improve accessibility, safety, and mobility around the home, and provide information about using ramps, low-riser steps, handrails, mechanical lifts, or elevators. The therapist can also suggest devices that control functions such as opening curtains, turning on lights, or adjusting music or TV settings from a wheelchair, armchair, or bed. He or she can source modified furniture such as beds or chairs to help with patients’ motor difficulties, and make longer-term recommendations that may include wet rooms or floor lifts.
  • Instruct a patient on the latest communications and computer technology to improve mobility, and on the use of assistive devices such as dressing aids, bathroom equipment (such as grab bars or a shower chairs), household helpers, adaptive eating utensils, transfer devices, and seating/mobility equipment that can help reduce barriers and promote independence.
  • Recommend the use of assistive devices to help in cooking and cleaning since patients’ impairments can prevent them from doing household chores. Different tools and utensils specifically designed to help people lacking hand strength and dexterity include rocker knives, electric can openers, hand blenders, and wheeled carts for transporting supplies.
  • Prescribe exercises to preserve hand strength and dexterity, including range-of-motion, coordination, and resistance exercises to overcome difficulties in completing everyday activities such as dressing, personal care tasks, meal preparation, eating, writing a check, or filling out forms.
  • Help patients find ways to compensate for cognitive deficits at home and work. MS patients can experience a range of cognitive problems such as short-term memory loss (for example, misplacing keys/glasses, forgetting names, missing appointments) and short attention span (for example, trouble concentrating on reading, losing track during a conversation, and being able to perform only one task at a time). Difficulty finding words, and impaired judgement and organizational skills (inability to plan or carry out activities, prioritize tasks, manage money, and balance checkbooks) are also common in MS. Inability to process information in a timely manner and to adapt to changing situations are also experienced by MS patients.
  • Work with a patient and/or their employer to find ways to remain at work for as long as possible. This may involve pacing strategies to maximize energy or workplace changes to overcome difficulties due to impairments.
  • Help manage a patient’s fatigue by planning daily activities in ways to conserve energy levels. These may include taking short breaks during the day between activities, and lukewarm or cool showers in the evenings because MS patients are prone to fatigue caused by heat. The therapist can advise on how to avoid overheating at home and work, and how to relax using meditation and other techniques to overcome fatigue.
  • Make and modify splints and orthotics, which are used for positioning, support, stabilization, mobilization, reduction of pain and spasticity, and prevention of contractures (reduced joint mobility). Sometimes, a splint or orthotic is all that is needed to enable a patient to carry out a certain task independently.
  • Assist with providing information about assistive technologies designed for use in cars if impairments make it difficult for a patient to operate an automobile. These devices can assist with steering, operating the gas pedal, and increasing visibility. The therapist can make suggestions about seat height, accessibility of cargo spaces, adequate storage for walking aids, and retrofitting an automobile to hold a carrier for a scooter or portable wheelchair.

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