Multiple Sclerosis


Multiple Sclerosis as a Comorbidity – Kristin B., Physical Therapist

Most therapists will encounter at least one patient with a primary diagnosis of Multiple Sclerosis (MS) during their career. Though there are many types, MS is a progressive disease that causes an array of symptoms related to the destruction of myelin sheaths that protect both sensory and motor nerves. The relationship between a therapist and a patient with MS is frequently ongoing. A therapist may work with the same patient for years or decades throughout the progression of the disease. Once a therapist is familiar with their patient, they can readily recognize the needs of the individual and provide treatment accordingly. This becomes more difficult, however, when you are treating a patient for a completely different diagnosis, who may also have MS, like in the case of a patient with hip fracture. Some things to consider when treating a patient with MS as a comorbidity:

1. Increased Fatigue- exercise programs may need to have decreased repetitions or more frequent rest breaks

2. Decreased Sensation- bracing or splinting will require more regular monitoring for skin breakdown

3. Blurred or Double Vision- exercise programs, instruction sheets and activities may have to be modified to account for visual deficits

4. Heat Sensitivity- temperature must be monitored to ensure that a patient isn’t over-heating, especially in the case of aquatic therapy

5. Swallowing Difficulties- some patients may develop difficulty with drinking water or consuming other textures and might require referral to speech therapy 

6. Weakness of Limbs- this should be considered when choosing an appropriate assistive device

7. Decrease Balance- nearly every patient with MS will experience increased risk of falls due to combined symptoms

8. Cognitive Deficits- patients with MS may have difficulty with problem solving or require increased time for processing

Though each person has different symptoms, this list is just a guideline of things to consider while working with a patient with MS as a primary or secondary diagnosis.

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