Multiple Sclerosis Rehabilitation

WHO WILL BENEFIT FROM REHAB?

• Every person with MS can benefit from a supervised Rehabilitation program.
• People with MS have a lifelong need for Rehabilitation and exercise interventions due to the progressive nature of the disease and their greater risk of the complications of inactivity.
• Scientific studies have demonstrated sustained functional benefit for individuals with MS who participated in Multidisciplinary Rehabilitation programs.
• Nowadays, Rehabilitation is one of the treatments of MS patients and should be viewed as an ongoing process to maintain and restore maximum function and quality of life.
• Participating in Rehab early on can establish positive behavior patterns that will come handy should other problems surface later.
• When and if activity limitations exist, Rehabilitation focuses on making the most of existing strength and abilities, at the same time as it emphasizes on education and energy management.
• It can also have important benefits for a person’s relationship with family and friends.
• Part of a rehab program may involve learning how to deal with changes in mobility; utilizing tools and mobility aids that allow full participation in activities with others; modifying environments to reduce restriction; and teaching other people how to provide assistance in ways that are physically and emotionally beneficial.

MULTIPLE SCLEROSIS REHABILITATION PROGRAM

Our Multiple Sclerosis Rehabilitation program brings together skilled professionals with different specialties in order to provide the best care and education for these patients and their families.

PHYSICAL THERAPIST

• PTs evaluate and address the person’s ability to move and function, with particular emphasis on walking and mobility, strength, balance, posture, fatigue and pain.
• Physical therapy might include an exercise program, gait training and training in the use of mobility aids (canes, crutches, scooters and wheelchairs) and other assistive devices.
• The goal is to promote safety, achieve and maintain optimal functioning, and prevent unnecessary complications such as de-conditioning, muscle weakness from lack of mobility and muscle contractures related to spasticity.
• Physical therapy can also include pelvic floor exercises which may help address urinary/bladder issues.

OCCUPATIONAL THERAPIST

• OTs goal is to enhance independence, productivity and safety in all activities related to personal care, leisure activities and employment.
• OTs provide training in energy conservation techniques and the use of adaptive tools and devices to simplify tasks at home and in the office.
• Recommend and provide strategic modifications to the home and workplace to ensure accessibility and convenience.
• Occupational therapists also evaluate and treat problems related with cognition and memory.

SPEECH LANGUAGE PATHOLOGIST (SLP)

• Evaluates swallowing and communication difficulties, which can arise from damage in the central nervous system that reduces control and/or coordination of the muscles used in these important functions.
• SLP also assist with evaluation and management of cognitive communication difficulties, such as problems with thinking, memory and/or speaking.
• The SLP may offer relevant strategies, teach functional skills and provide caregiver family/caregiver education for specific problems. If speech impairment is severe, alternative means of communication, such as gesture, alphabet/word boards may be recommended.
• If experiencing swallowing difficulties, SLP may advise on how to manage different consistencies of food and/or liquid. Specific strategies may be recommended to help you swallow more effectively.
• The goal is to promote safety, preventing complications such as dehydration, poor nutrition, or aspiration pneumonia (when food or liquids enter the lungs).

OTHER MEDICAL PROFESSIONAL INVOLVED:

NEUROLOGIST

A neurologist is a doctor specialized in the diagnosis and management of conditions affecting the brain and nervous system including multiple sclerosis, Parkinson’s disease, epilepsy and dementia. Once a diagnosis of MS is confirmed the Neurologist will outline the therapeutic options which will vary according to each patient. They may also refer the patient to other services (Rehab; Nursing; Social Worker).

DIETITIAN

The dietitians’ role is to assess a person’s nutritional status and provide evidenced based advice to promote optimal health and nutrition. A dietitian can enable people to adapt their diet to best manage their symptoms of MS such as constipation and bladder problems. Your dietitian can also help you to achieve and maintain a healthy body weight and manage common comorbidities such as diabetes and cardiovascular disease.

NURSE

MS specialist nurses play an integral role in providing support to the patient whilst also participating in the prevention and management of symptoms. Nurses can help in the management of bowel and bladder dysfunction. This may involve the use of a toileting regime, education on continence management techniques and even teaching patients to self-catheterize.

SOCIAL WORKER / CASE MANAGER

The social worker assists people with MS and their family members to connect to essential community resources related to employment, home modifications, disability applications, long-term care or any other services they may require. In many settings, the social worker also provides counseling services, supports people navigate their way through difficult treatment decisions and other challenges they encounter over the course of the disease.

PSYCHIATRIST

A Psychiatrist can assess the pattern and severity of a person's cognitive symptoms and develop individual treatment programs based on cognitive neuropsychiatry. This is an evidence based approach that explores an individual's cognitive weaknesses and strengths to find ways to manage and reduce the impact of their symptoms.

THE GOAL OF THIS REHABILITATION PROGRAM

This neurological rehabilitation program is designed to meet the needs of the individual patient, depending on the type of level of progression of MS. Active involvement of the patient and family is vital to the success of the program.

The goal of neurological rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life — physically, emotionally, and socially.

In order to help reach these goals, the CCAD neurological rehabilitation program includes the following aspects:

• Activities to improve mobility (movement), muscle control, gait (walking), and balance
• Exercise programs to improve movement, prevent or decrease weakness caused by lack of use, manage spasticity and pain, and maintain range of motion
• Assistance with activities of daily living (ADLs), such as eating, dressing, bathing, toileting, handwriting, cooking, and basic housekeeping
• Nutritional counseling
• Speech therapy to help patients with speaking, reading, writing, or swallowing
• Stress, anxiety, and depression management
• Involvement in community support groups
• Activities to improve cognitive impairments, such as problems with concentration, attention, memory, and poor judgment
• Help with obtaining assistive devices that promote independence
• Patient and family education and counseling
• Pain management

Rehabilitation is one of the components of the comprehensive management of MS that focuses on function, and adds non-pharmacological strategies for the care of the person.

Our mission is to encourage autonomy and improve the quality of life through goaloriented interventions by the person with MS in deciding on treatment priorities.

Further information about MS is available in CCAD’s Patient and Family Education Database, with the specific topics of:

• How is Multiple Sclerosis Diagnosed
• Exercise and Multiple Sclerosis
• Fatigue in Multiple Sclerosis
• Primary Progressive Multiple Sclerosis
• Treating Multiple Sclerosis with Botox
• Common Multiple Sclerosis Perceptions