Multiple sclerosis (MS) is an autoimmune disease that causes demyelination of nerve pathways in the brain and spinal cord, impairing signal transmission. There are four stages of MS: relapsing-remitting, secondary progressive, primary progressive, and progressive-relapsing. Symptoms vary by individual but may include fatigue, tremors, cognitive changes, sensory deficits, weakness, and mobility issues. Occupational therapy can help people with MS through fatigue management, controlling tremors, cognitive compensation strategies, improving sensory function, strength and endurance training, contracture prevention, improving activities of daily living, and use of adaptive equipment.
2. What is Multiple Sclerosis (MS)? MS is a autoimmune disease where the myelin surrounding the nerve pathways, which transmit signals through the brain and spinal cord, are slowly diminishing. This is a process called demyelization. After this occurs the body produces scar tissue or plaque around these nerve pathways. Due to this, the body is unable to transmit information quickly if at all.
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4. Secondary Progressive: In this stage the disorder is progressing at a variable rate. This stage normally takes many years to form; approximately 10-25 years.
6. Progressive Relapsing: Progressive from the onset with clear acute relapses. (Relates to 5% of those diagnosed with MS) ***In the chronic stages, patient will be treated with medical management. This may include, catheterization, tube feeding, or surgical release of tendons for contractures.***
7. Symptoms of MS Symptoms of MS often occur in episodes or attacks. Although occasionally the person with MS may experience an attack due to certain triggers most episodes are most likely not expected to the person with MS but instead happen for no reason at all. The following may contribute to attack: Spring/summer Infections Stress Pregnancy Symptoms will vary from each person with MS. It depends on the stage of the disease process and the location of scar tissue within the body.
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9. Control of tremors: Interventions Occupational Therapy may use are: splinting (support of the limbs), use of weights, activities focused on trunk support, controlling fatigue through energy conservation techniques, and decrease fine motor coordination demands.
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13. Mobility- patient with MS may require a wheelchair. Before recommending this, there are some considerations: overall endurance, trunk control, lower extremity strength (legs), upper extremity strength (arms), and disease prognosis.
