Life with MS

Small Changes Can Improve Mobility, Independence

By Dr. Herb Karpatkin and Michael Zerves
Although multiple sclerosis is known as a disease that affects the brain and spinal cord, as physical therapists that specialize in MS, we tend to think of MS as a disease of mobility. Patients come to us for help in becoming more independent in tasks requiring their body to perform functions such as walking, balancing, climbing stairs, and getting in and out of bed. We are often 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 cure for the disease, there are many relatively small things that can be done that may have a positive effect. The purpose of this brief article is to make suggestions about a few small changes that people with MS can make that may result in a large improvement in mobility, function, and independence.

• Move your body more! Most people with MS are too sedentary, and this may result in worsening of some symptoms. In other words, a lack of movement can make the disease worse, so increasing movement can lead to an improvement in symptoms and function. The increase in moving does not have to be drastic, but it should be consistent; try walking an extra few steps each day, then slowly increase the amount of steps over time. If walking is too difficult, you can perform some exercises with your arms, or exercises for your legs lying down, or seated in a chair. If you are not sure what types of exercise to perform, speak with a physical or occupational therapist who is knowledgeable about MS.

• Manage your weight. Because most persons with MS are sedentary, they are also more prone to weight gain. Weight loss is especially problematic for persons with MS, because increases in weight lead to an increase in the amount of energy needed for movement. Fatigue is one of the most common symptoms in MS, so anything that decreases the energy cost of movement will be helpful. Similar to adding a few extra steps or performing a few more exercises a 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 ability to perform large amounts of work without taking a break. However, if you intersperse periods of work with periods of recovery, you can accomplish a greater amount of work than if you did not take a break. This idea has been demonstrated in research studies and can easily be applied to daily activities.

• Use a fitness tracker. Most people with MS are not aware how much or how little they move. A fitness tracker can provide objective data as to how many steps are taken each day, not only giving accurate information on how much you move, but also helping with setting goals to move more. They can also set reminders and/or send you text messages during the day to help motivate you to move and/or exercise. Fitness tracking devices are readily available, either as an app on your smartphone or as a separate device.

• Manage temperature better. Most, if not all, people with MS are affected by temperature. The most common scenario is worsening of physical function in situations where there is high heat or humidity. There are several simple interventions that can be done to manage this issue. One of the simplest is to use cooling garments. MS Focus: the Multiple Sclerosis Foundation is able to provide a free cooling vest that can help in the summer months, or even while performing exercises. Another way to stay cool is to make sure your home and/or workplace has adequate air-conditioning. Since humidity can be as big a problem as heat, using a dehumidifier can also be helpful.

Hopefully, we have shown that many of these small changes can have huge effects on your day-to-day life. Technology is ever growing, and there are many options available to help you move more and feel better. Find whatever works best for you and create a daily routine that fits into your life. In addition to working on your own, finding a physical or occupational therapist with specific training in MS can help you set up exercise programs that are tailored to your specific needs.

As we said earlier, a diagnosis of MS can lead to feelings of helplessness. We hope that with this article, we have provided a number of small steps that can be undertaken by anyone with MS, and as a result, feel like they have more control over their disease.