Living With Multiple Sclerosis

March is National MS Education and Awareness Month. Multiple Sclerosis (MS) is a clinical condition characterized by a loss of the myelin tissue that surrounds the nerves and aids in normal conduction of electrical impulses.

Common symptoms include weakness in the arms or legs, loss of balance and problems with mobility and bladder function. While the condition itself cannot be cured, treatment is aimed at slowing down the progression of the disease and helping patients recover to a point where they are independent at home. Physical therapy plays an important role in the rehabilitation process and improves quality of life for patients with MS.

The purpose of physical therapy is to ensure that the patient maintains a degree of functionality and is able to perform daily activities without too much difficulty.

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Thought for The Day

The Various Stages of Multiple Sclerosis

Physical therapy is an important part of the treatment process during the different stages of MS. During the initial evaluation, the therapist will determine if there are any limitations with skin sensation, muscle strength and overall function.

As the disease progresses, acute attacks are likely to occur and the patient may need to be hospitalized. In such cases, a physical therapist will work closely with physicians and other specialists in the healthcare team to complement their efforts and to ensure quick recovery for the patient.

MS can also present as a slow, progressive condition that relapses a number of times and seems to 'go away'. Don't be fooled, because it can cause severe limitations over time.

In some situations, the side-effects are minimal and daily life is not impaired. Each person's progression is different. Your physical therapist will always assess the most important functional problems affecting you and will address those needs in a comprehensive, customized treatment program.

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Message From Your Physical Therapist

This is How We Help...

Supervised, controlled exercise is the foundation of physical therapy treatment. As patients tend to fatigue quickly, exercise plans are designed to be simple and gradual. Exercise programs are also designed to be intermittent to prevent sudden 'attacks' of pain and discomfort. Here are some of the benefits of physical therapy in MS.

1. Correction of posture and improved trunk control – Patients with MS are at risk of falling, so physical therapy is aimed at controlling posture and balance to minimize the risk of falls.
2. Increasing functional independence with walking aids – To improve independence and movement, a physical therapist may prescribe aids including walkers, canes, and custom made foot orthoses (supports). Conditions such as foot drop and loss of sensation in the lower extremities may warrant the use of additional orthoses.
3. Enhancing mobility – Mobility is an important prerequisite to patient independence. Joint and muscle stiffness (especially in the legs) can be corrected with stretching exercises. Stiffness in the neck muscles can affect neck and head posture and control, which can also be corrected with supports and exercise.
4. Restoration of muscle tone - Increased tone (hypertonia) or decreased muscle tone (hypotonia) is a result of the impact of MS on the nerves. A physical therapist may use manual techniques to improve joint sensation and restore normal muscle tone.

Physical therapists play an important role in the management of patients with MS and several other conditions affecting the nerves, muscles, bones, and joints. If you or someone you know needs help, we are just a phone call away. There is a lot that physical therapists can do to help you (and everyone you know) live an independent, pain-free lifestyle. Give us a call today, and we'll show you what we can do for you.

The Role of Physical Therapy in Treating MS

Physical therapy can help with:

Balance problems
Incoordination
Fatigue
Pain
Weakness
Posture
Difficulty physically performing daily activities (such as walking or getting up from a sitting position)

The goal of physical therapy is to improve your independence and quality of life by improving movement and function, and relieving pain.

Why do I have symptoms with MS?

Multiple sclerosis (MS) damages the myelin sheath surrounding the nerve cells of the brain and spinal cord. Scarring from this damage can block or slow nerve impulses in areas of the brain (neurological damage). As a resume activities you may lack coordination, feel tired, have involuntary movements, resist movement (spasticity), and have pain. Symptoms such as these, which are a result of MS, are called "primary symptoms."

Primary symptoms can make you move less. As a result, you may feel tightness, pain and weakness, especially in the muscles and joints. These symptoms, which are not a result of MS, are called "secondary symptoms."

How can physical therapy improve my symptoms?

Primary symptoms

Physical therapy cannot cure primary symptoms because, at this time, neurological damage cannot be reversed. Physical therapy can be helpful by providing "compensatory" treatments. These treatments enable you to compensate for the changes brought about by MS. Compensatory treatments include learning new movement techniques, strategies, and equipment.

Secondary symptoms

Physical therapy can be very helpful at lessening and even stopping secondary symptoms of MS. A physical therapist can teach you exercises you can use to strengthen and stretch muscles. Many of these exercises can be performed at home.

How can I receive physical therapy?

If you feel you can benefit from physical therapy, you will need to ask your physician for a referral to physical therapy.

How many visits will I need?

The number of appointments depends on your specific situation. The first appointment includes an evaluation and recommendations for exercises. The following appointments check your progress and build a new program. The therapist will work with you until you reach a certain level of improved function. At that point, a home exercise program will be developedSee More

Last Friday, something important happened in Washington DC.

Automatic spending cuts were triggered, cuts that will lead to
a reduction of $11 billion in payments to healthcare providers
(including physical therapists) for a variety of s...ervices.

That equates to a 2% reduction in Medicare payments.

It's very likely that private insurers will follow.

Not many are happy about it, including the President. (In fact, his
exact words were "Forced budget cuts are dumb").

Patients will feel the impact.

There are 47 million Medicare patients in the United States (15% of
the population) and soon, they may have a tough time finding providers.

THE IMPACT FOR PHYSICAL THERAPY PRIVATE PRACTICE?

The more Medicare patients in a practice and the lower the profit margins,
the greater the hit on the practice.

Such practices may be forced, out of necessity, to turn away some Medicare
patients.

Here's the real tipping point.

The Medicare Multiple Procedure Payment Reduction (MPPR), set to go into
effect on April 1, 2013 (despite the best efforts of the APTA) will result
in a 6-7% decrease in payments for outpatient therapy services unless
Congress takes action to stop it.

This adds insult to injury, because we already experienced a 6-7% payment cut in 2011.

In 2013, the combination of the federal payment cuts and MPPR could lead to a
FURTHER 9% cut in Medicare payments.

PTs aren't the only ones affected.

According to Dr. Jeremy Lazarus, president of the American Medical Association in
an article on CNN:

"Over the last 12 years, Medicare payments to physicians have increased by only 4%,
while the cost of providing care has jumped 20%"

In fact, Congress has blocked Medicare payment cuts from happening more than 20
times in the past 10 years.

What if they can't continue to block payment cuts anymore?

WHAT SHOULD YOU DO ABOUT THIS?

Asking members of Congress to delay implementation of MPPR is a startSee More

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The Connection Between Stroke and Physical Therapy
A stroke can affect men and women of all ages and carries with it damaging and potentially life-threatening complications. Simply stated, a stroke refers to an unexpected loss of brain function that occurs when blood flow to the brain is interrupted or when blood vessels in the brain rupture. When the blood flow is affected, the brain cells in the affected area die, and this can cause long-term damage. Depending on the area injured, a stroke can cause an individual to lose his or her ability to see, speak, read or write, along with loss of memory or an impaired thought process. Also, movement is limited to partial or full paralysis. The slightest of delays in blood flow can cause damage to the brain. The longer the brain is without important nutrients and oxygen carried by the blood, the higher the risk of permanent damage. So, what are the risk factors of stroke? They are high blood pressure, high cholesterol levels, certain heart conditions, diabetes, obesity, smoking, stress, and drinking too much alcohol. In addition women are subject to an extra set of risk factors, such as menopause and hormonal changes, as well as conditions associated with pregnancy and the use of birth control pills. A low activity level has further been linked to stroke risk, bringing yet another benefit to regular exercise. Fortunately, you can identify a stoke early through FOUR MAJOR WARNING SIGNS and potentially decrease the severity of the damage: Weakness or numbness in the face, arm or leg Speech or comprehension trouble, vision problems Headache Dizziness Each of these warning signs can occur alone or in any combination. So, learn and remember the list. Remember, timing is key. Getting treatment quickly can help counteract the damaging effect of a stroke. So if any of these warning signs occur, be sure to get medical attention immediately!
Impact of a Stroke
Knowing the warning signs of a stroke can not only save your own life, but that of someone close to you as well. In fact, most of us know someone who has suffered a stroke and have seen its damaging effects. Share this information with members of your family, especially those who are aging, and you just may save a life.
Physical Therapy and Stroke Recovery
You may not expect physical therapy to play an important part in stroke recovery, but it is often referred to as an indispensable tool. While there are other types of stroke rehabilitation, including speech and occupational therapy, physical therapy specifically addresses physical damage. Of course, the type of assistance necessary depends on the type of damage that is present. As physical therapists, we are trained to teach strengthening exercises to retrain the body following a stroke. Using a series of custom-designed stretches and exercises, we can help a stroke victim broaden his or her range of motion, build muscle, and increase endurance. Before establishing a treatment plan, we test the stroke victim’s current levels of motion, strength and endurance, and use this valuable information to create a plan that best suits the individual. Word of Caution: Never underestimate the range of treatment provided by your physical therapist. Even if the stroke victim is suffering from partial paralysis or weakness as a result of the stroke, physical therapy can prove to be very beneficial. In the case of paralysis, we can teach the stroke victim ways to compensate for the loss, in addition to prescribing treatment for the affected limb(s). For stroke sufferers forced to combat ongoing weakness, physical therapy can help to strengthen the extremities as a long-term solution.Physical therapy plays an integral role in stroke recovery. If you or someone you know has suffered a stroke, contact your physical therapist now to open a new door to recovery.