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Although disease-modifying treatments help slow disease progression, most people living with MS will continue to have limitations of one kind or another. Rehabilitation in MS involves the intermittent or ongoing use of interdisciplinary strategies to promote functional independence, prevent complications, and enhance overall quality of life (visit the Rehabilitation Paradigm). It is an active process, beginning early in the disease course, which is directed toward helping the person maintain and/or recover the highest possible level of functioning, and realize her or his optimal physical, mental, and social potential given any limitations that exist.

Rehabilitation recommendations for persons with Multiple Sclerosis (abridged)

  • The physician, nurse practitioner (NP), or physician assistant (PA) should consider referring a person for a rehab assessment when there is an abrupt or gradual  worsening of function or increase in impairment that impacts mobility, safety, independence, and/or quality of life.
  • A patient who presents with any functional limitation should be evaluated and appropriately managed.
  • Assessment for rehab services should be considered early in the disease when behavioral and lifestyle changes may be easier to implement.
  • The frequency, intensity, and setting of the rehab intervention must be based on individual needs. Whenever possible, patients should be evaluated and treated by therapists who are familiar with neurological degenerative disorders.
  • Rehab interventions should be used in conjunction with other medical interventions to address: mobility impairments, fatigue, pain, dysphagia, bladder/bowel dysfunction, decreased independence in ADLs, impaired communication, diminished quality of life, depression and other affective disorders, cognitive dysfunction.
  • Appropriate assessments and outcome measures must be applied periodically to establish and revise goals, and to measure outcomes.
  • Known complications of MS (contractures, disuse atrophy, pressure sores, risk of falls, increased dependence) can be reduced or prevented by rehab interventions.
  • Maintenance of function, optimal participation, and quality of life are key outcomes.
  • Maintenance therapy is designed to preserve current status of ADLs, safety, mobility, and quality of life, and to reduce the rate of deterioration and risk of complications.
  • A thorough assessment for wheelchairs and other durable medical equipment, as well as for environmental modifications, will result in the use of the most appropriate equipment.
  • Regular communication between the referring healthcare provider and the rehab professionals will facilitate high quality, comprehensive care.

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