b'Symptom ManaEementS maallllCChhaannggeessCCaannSmI mpprroovveeMMoobbiilliittyy,,ImI nddeeppeennddeenncceeInBody movement, weight loss arejust a few of the changes you can make.By Dr. Herb Karpatkin and Michael ZervesAlthough multiple sclerosis is known as a disease that aects the brain and spinal cord, asphysical therapists that specialize in MS, we tend to think of MS as a disease of mobility. Patientscome to us for help in becoming more independent in tasks requiring their body to performfunctions such as walking, balancing, climbing stairs, and getting in and out of bed. We areoften struck by the sense of helplessness many people with MS feel as a result of their diagnosis,and that feeling may become a symptom of the disease itself. Although there is no known curefor the disease, there are many relatively small things that can be done that may have a positiveeect. The purpose of this brief article is to make suggestions about a few small changes thatpeople with MS can make that may result in a large improvement in mobility, function, andindependence. Move your body more! Most people with MS are too sedentary, and this may result inworsening of some symptoms. In other words, a lack of movement can make the diseaseworse, so increasing movement can lead to an improvement in symptoms and function. Theincrease in moving does not have to be drastic, but it should be consistent; try walking anextra few steps each day, then slowly increase the amount of steps over time. If walking is toodicult, you can perform some exercises with your arms, or exercises for your legs lyingdown, or seated in a chair. If you are not sure what types of exercise to perform, speakwith a physical or occupational therapist who is knowledgeable about MS. Manage your weight. Because most persons with MS are sedentary, they are also more proneto weight gain. Weight loss is especially problematic for persons with MS, because increasesin weight lead to an increase in the amount of energy needed for movement. Fatigue is oneof the most common symptoms in MS, so anything that decreases the energy cost of move-ment will be helpful. Similar to adding a few extra steps or performing a few more exercisesa day, making minor adjustments to your diet can go a long way.Try to intersperse periods of activity with periods of rest. MS fatigue compromises the abilityto perform large amounts of work without taking a break. However, if you intersperse periodsof work with periods of recovery, you can accomplish a greater amount of work than if youdid not take a break. This idea has been demonstrated in research studies and can easily beapplied to daily activities.msfocusmagazine.org 14'