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.

article_body

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.

tips_body

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

Stretching at work.

Our New State of the Art 6600 square ft facility
Physical Therapy Helps!
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.

Suffering from Arthritis aches and pains?
here is some good information to help...

http://www.therapynewsletter.com/myarchive.php?userid=385&id=12710&secret=3ec6a0ea4163d1ce

Preview Newsletter Design

www.therapynewsletter.com

This note is to convey my heartfelt gratitude for the excellent work you are doing in providing physical rehabilitation for my husband, Vincent R. Before he undertook his physical rehabilitation, the probability that he would need to be taken to a nursing home became a virual reality.

 

 

Heart-healthy diet: 8 steps to prevent heart disease

 

Although you might know that eating certain foods can increase your heart disease risk, it's often tough to change your eating habits. Whether you have years of unhealthy eating under your belt or you simply want to fine-tune your diet, here are eight heart-healthy diet tips. Once you know which foods to eat more of and which foods to limit, you'll be on your way toward a heart-healthy diet.

1. Control your portion size

How much you eat is just as important as what you eat. Overloading your plate, taking seconds and eating until you feel stuffed can lead to eating more calories, fat and cholesterol than you should. Portions served in restaurants are often more than anyone needs. Keep track of the number of servings you eat — and use proper serving sizes — to help control your portions. Eating more of low-calorie, nutrient-rich foods, such as fruits and vegetables, and less of high-calorie, high-sodium foods, such as refined, processed or fast foods, can shape up your diet as well as your heart and waistline.

A serving size is a specific amount of food, defined by common measurements such as cups, ounces or pieces. For example, one serving of pasta is 1/2 cup, or about the size of a hockey puck. A serving of meat, fish or chicken is 2 to 3 ounces, or about the size and thickness of a deck of cards. Judging serving size is a learned skill. You may need to use measuring cups and spoons or a scale until you're comfortable with your judgment.

2. Eat more vegetables and fruits

Vegetables and fruits are good sources of vitamins and minerals. Vegetables and fruits are also low in calories and rich in dietary fiber. Vegetables and fruits contain substances found in plants that may help prevent cardiovascular disease. Eating more fruits and vegetables may help you eat less high-fat foods, such as meat, cheese and snack foods. Featuring vegetables and fruits in your diet can be easy. Keep vegetables washed and cut in your refrigerator for quick snacks. Keep fruit in a bowl in your kitchen so that you'll remember to eat it. Choose recipes that have vegetables or fruits as the main ingredient, such as vegetable stir-fry or fresh fruit mixed into salads.  

Fruits and vegetables to choose	Fruits and vegetables to avoid
·         Fresh or frozen vegetables and fruits ·         Low-sodium canned vegetables ·         Canned fruit packed in juice or water	·         Coconut ·         Vegetables with creamy sauces ·         Fried or breaded vegetables ·         Canned fruit packed in heavy syrup ·         Frozen fruit with sugar added

 

3. Select whole grains

Whole grains are good sources of fiber and other nutrients that play a role in regulating blood pressure and heart health. You can increase the amount of whole grains in a heart-healthy diet by making simple substitutions for refined grain products. Or be adventuresome and try a new whole grain, such as whole-grain couscous, quinoa or barley. Another easy way to add whole grains to your diet is ground flaxseed. Flaxseeds are small brown seeds that are high in fiber and omega-3 fatty acids, which can lower your total blood cholesterol. You can grind the seeds in a coffee grinder or food processor and stir a teaspoon of them into yogurt, applesauce or hot cereal.

Grain products to choose	Grain products to limit or avoid
·         Whole-wheat flour ·         Whole-grain bread, preferably 100% whole-wheat bread or 100% whole-grain bread ·         High-fiber cereal with 5 g or more of fiber in a serving ·         Whole grains such as brown rice, barley and buckwheat (kasha) ·         Whole-grain pasta ·         Oatmeal (steel-cut or regular) ·         Ground flaxseed	·         White, refined flour ·         White bread ·         Muffins ·         Frozen waffles ·         Corn bread ·         Doughnuts ·         Biscuits ·         Quick breads ·         Granola bars ·         Cakes ·         Pies ·         Egg noodles ·         Buttered popcorn ·         High-fat snack crackers

 

4. Limit unhealthy fats and cholesterol

Limiting how much saturated and trans fats you eat is an important step to reduce your blood cholesterol and lower your risk of coronary artery disease. A high blood cholesterol level can lead to a buildup of plaques in your arteries, called atherosclerosis, which can increase your risk of heart attack and stroke.

The American Heart Association offers these guidelines for how much fat and cholesterol to include in a heart-healthy diet:

Type of fat	Recommendation
Saturated fat	Less than 7% of your total daily calories, or less than 14 g of saturated fat if you follow a 2,000-calorie-a-day diet
Trans fat	Less than 1% of your total daily calories, or less than 2 g of trans fat if you follow a 2,000-calorie-a-day diet
Cholesterol	Less than 300 mg a day for healthy adults; less than 200 mg a day for adults with high levels of LDL ("bad") cholesterol or those who are taking cholesterol-lowering medication

The best way to reduce saturated and trans fats in your diet is to limit the amount of solid fats — butter, margarine and shortening — you add to food when cooking and serving. You can also reduce the amount of saturated fat in your diet by trimming fat off your meat or choosing lean meats with less than 10 percent fat. You can also use low-fat substitutions when possible for a heart-healthy diet. For example, top your baked potato with salsa or low-fat yogurt rather than butter, or use low-sugar fruit spread on your toast instead of margarine. You may also want to check the food labels of some cookies, crackers and chips. Many of these snacks — even those labeled "reduced fat" — may be made with oils containing trans fats. One clue that a food has some trans fat in it is the phrase "partially hydrogenated" in the ingredient list. When you do use fats, choose monounsaturated fats, such as olive oil or canola oil. Polyunsaturated fats, found in nuts and seeds, also are good choices for a heart-healthy diet. When used in place of saturated fat, monounsaturated and polyunsaturated fats may help lower your total blood cholesterol. But moderation is essential. All types of fat are high in calories.

Fats to choose	Fats to limit
·         Olive oil ·         Canola oil ·         Margarine that's free of trans fats ·         Cholesterol-lowering margarine, such as Benecol, Promise Activ or Smart Balance	·         Butter ·         Lard ·         Bacon fat ·         Gravy ·         Cream sauce ·         Nondairy creamers ·         Hydrogenated margarine and shortening ·         Cocoa butter, found in chocolate ·         Coconut, palm, cottonseed and palm-kernel oils

5. Choose low-fat protein sources

Lean meat, poultry and fish, low-fat dairy products, and egg whites or egg substitutes are some of your best sources of protein. But be careful to choose lower fat options, such as skim milk rather than whole milk and skinless chicken breasts rather than fried chicken patties. Fish is another good alternative to high-fat meats. And certain types of fish are rich in omega-3 fatty acids, which can lower blood fats called triglycerides. You'll find the highest amounts of omega-3 fatty acids in cold-water fish, such as salmon, mackerel and herring. Other sources are flaxseed, walnuts, soybeans and canola oil. Legumes — beans, peas and lentils — also are good sources of protein and contain less fat and no cholesterol, making them good substitutes for meat. Substituting plant protein for animal protein — for example, a soy or bean burger for a hamburger — will reduce your fat and cholesterol intake.

Proteins to choose	Proteins to limit or avoid
·         Low-fat dairy products such as skim or low-fat (1%) milk, yogurt and cheese ·         Egg whites or egg substitutes ·         Fish, especially fatty, cold-water fish, such as salmon ·         Skinless poultry ·         Legumes ·         Soybeans and soy products, for example, soy burgers and tofu ·         Lean ground meats	·         Full-fat milk and other dairy products ·         Organ meats, such as liver ·         Egg yolks ·         Fatty and marbled meats ·         Spareribs ·         Cold cuts ·         Hot dogs and sausages ·         Bacon ·         Fried or breaded meats

6. Reduce the sodium in your food

Eating a lot of sodium can contribute to high blood pressure, a risk factor for cardiovascular disease. Reducing sodium is an important part of a heart-healthy diet. The Department of Agriculture recommends:

·         Healthy adults have no more than 2,300 milligrams (mg) of sodium a day (about a teaspoon)

·         People age 51 or older, African-Americans, and people who have been diagnosed with high blood pressure, diabetes or chronic kidney disease have no more than 1,500 mg of sodium a day. Although reducing the amount of salt you add to food at the table or while cooking is a good first step, much of the salt you eat comes from canned or processed foods, such as soups and frozen dinners. Eating fresh foods and making your own soups and stews can reduce the amount of salt you eat. If you like the convenience of canned soups and prepared meals, look for ones with reduced sodium. Be wary of foods that claim to be lower in sodium because they are seasoned with sea salt instead of regular table salt — sea salt has the same nutritional value as regular salt.

Another way to reduce the amount of salt you eat is to choose your condiments carefully. Many condiments are available in reduced-sodium versions, and salt substitutes can add flavor to your food with less sodium.

Low-salt items to choose	High-salt items to avoid
·         Herbs and spices ·         Salt substitutes ·         Reduced-salt canned soups or prepared meals ·         Reduced-salt versions of condiments, such as reduced-salt soy sauce and reduced-salt ketchup	·         Table salt ·         Canned soups and prepared foods, such as frozen dinners ·         Tomato juice ·         Soy sauce

 7. Plan ahead: Create daily menus

You know what foods to feature in your heart-healthy diet and which ones to limit. Now it's time to put your plans into action. Create daily menus using the six strategies listed above. When selecting foods for each meal and snack, emphasize vegetables, fruits and whole grains. Choose lean protein sources and limit high-fat and salty foods. Watch your portion sizes and add variety to your menu choices. For example, if you have grilled salmon one evening, try a black-bean burger the next night. This helps ensure that you'll get all of the nutrients your body needs. Variety also makes your meals and snacks more interesting.

8. Allow yourself an occasional treat

Allow yourself an indulgence every now and then. A candy bar or handful of potato chips won't derail your heart-healthy diet. But don't let it turn into an excuse for giving up on your healthy-eating plan. If overindulgence is the exception, rather than the rule, you'll balance things out over the long term. What's important is that you eat healthy foods most of the time.

Incorporate these eight tips into your life, and you'll continue to find that heart-healthy eating is both doable and enjoyable. With planning and a few simple substitutions, you can eat with your heart in mind.