Physical Therapy: FAQs About Interventions
The goals of physical therapy are to maintain physical functioning, patient safety, quality of life, and independence. Your physical therapist (PT) will use a range of interventions to help you achieve these goals, including:
- Education about physical symptoms of MS and what you can do to alleviate these symptoms
- An individualized exercise program to address symptoms and maximize health and physical function
- Aids and adaptive equipment for home, office, and automobile to enhance mobility and functionality
- Physical therapy interventions (massage, ultrasound) to address specific impairments
- Use of community resources that support goals of physical therapy
Is a physical therapist (PT) the same as a physiatrist?
A physiatrist is a doctor who specializes in rehabilitation medicine and typically works in a rehabilitation center or clinic. Physical therapy is a separate health specialty that is more narrowly focused on physical or assistive interventions that address symptoms and disabilities. Consider walking difficulties, for example. If you see a physiatrist at a rehabilitation clinic, he or she may decide to use the services of a PT to address your problem with exercises or mobility aids or, as a doctor, your physiatrist may decide to prescribe a medication like Ampyra (dalfampridine).
What types of exercises does a PT recommend for people with MS?
Your PT may decide that you will benefit from one or more of several different types of exercise, such as those shown in the table below. Exercises can generally be categorized according to whether they are (1) active (exercises that you perform independently or by yourself), (2) active-assisted (exercises that require the assistance of a machine or person), or (3) passive (exercises that are done using an assistant or machine and do not require any active participation).
Different Types of Exercise Your PT May Recommend
- Goal to improve or maintain strength and endurance
- Examples: weight training, elastic bands, resistance machines
- Goal to ensure that joints move through full range of motion
- Used to address tightness in joint capsule, tendons, and ligaments
- Goal to restore or maintain flexibility or elasticity in muscles or tendons and to prevent contractures
- Goal to improve endurance and cardiorespiratory function
- May be effective in reducing fatigue
- Goal to improve balance and coordination for increased mobility and safety
How will exercise help me?
Exercises, especially under the supervision of your PT, can help address many of the most common MS symptoms. It is true that exercise takes some self-discipline, but the rewards of regular exercise will definitely repay the time and effort you put in. The table below shows some types of exercises and how they address specific symptoms.
Exercise and Common MS Symptoms
Is physical therapy effective in reducing MS pain?
Your PT has several tools available to help you with types of pain that are common in people with MS. In MS, pain can result from nerve damage or can be related to other MS symptoms, such as spasticity or problems with balance or coordination that cause back or joint pain. Your PT may use heat or ice for localized pain and instruct you in proper positioning or support to address joint or back pain resulting from poor balance or coordination. Additionally, if your pain results from improper use of ambulatory aids, such as crutches or walkers, your PT can help you learn the correct use of these aids. Pain related to spasticity can be effectively addressed using stretching and range of motion exercises.
Can exercise help restore the ability to walk?
If you have lost the ability to walk due to nerve damage related to MS, the question of whether exercise can help you recover this ability depends on the extent and nature of the damage. Unfortunately, exercise cannot undo nerve damage. However, your PT can give you exercises that will encourage your muscles to work as well as they are able and to prevent further decline in muscle strength.
If I’m unable to walk, is it necessary to exercise?
Even if you cannot walk, it is very important to continue to engage in regular exercise. Your PT can recommend the types of exercises that will give you the most benefit and instruct you on how to perform those exercises correctly. If you are immobile, exercise can help you remain flexible, improve endurance and strength, keep proper posture, and improve your sense of well-being. The table below highlights the benefits of exercises for a person who is wheelchair-bound.
Benefits of Exercise for Person Who is Wheelchair Bound
Can my PT help me choose a walking or mobility aid?
Your PT is specially trained to help you deal with mobility problems, whether related to poor balance, loss of coordination, or lack of strength in your legs. Your PT will assess the problem and recommend different options. Then, when the right aid has been selected, your PT will instruct you in the proper use. Some mobility aids that may be recommended include a cane, forearm crutch, quad cane, or four-wheeled rollator walker.
What can a PT do for me if I’m having problems with tripping or falling?
If you are having problems with tripping or falling, the first step is to find out what’s causing the problem. It may result from weakness in the foot, ankle, leg, or hip muscles, or a loss of coordination or balance, or fatigue or weakness. Once your PT has evaluated you and determined the cause of your tripping or falling, he or she may recommend exercises to strengthen the muscles that have weakened or other exercises to help you increase your balance or coordination. Your PT may also recommend the use of orthotics, such as an ankle-foot orthosis (AFO) to increase stability, or an electrical device that straps onto your leg and gives you functional electrical stimulation (FES) to help you lift your foot or decrease foot drop. If your problem stems from weakness or fatigue, your PT may recommend use of a motorized scooter for covering long distances.