Although there is no cure for multiple sclerosis (MS), occupational therapy can help a person manage symptoms, carry out daily activities, and maintain as much independence as possible.
Occupational therapy for people with MS aims to help them perform everyday tasks, such as folding clothes, driving to work, and walking.
Occupational therapy is different from physiotherapy because it focuses on general function rather than physical abilities. As a result, each person’s treatment plan prioritizes different goals based on their lifestyle and the progression of their MS.
This article discusses how occupational therapy for MS works, including how occupational therapists create a treatment plan and what exercises it might include. It also covers other treatment options and the outlook for people with MS.
Occupational therapy Goals to help a person perform their usual activities, which means that the specific goal will vary among individuals. In most programs, occupational therapists focus on three specific areas:
- personal care activities, such as taking a bath and using the bathroom
- productive activities, which may include cooking, paid work, childcare, or volunteering
- leisure activities, such as gardening, exercising, or other activities that a person enjoys
Occupational therapy does not follow a single treatment. Instead, it combines various activities and exercises, including:
- teach a person to work around their weaknesses
- use assistive devices
- increase strength
- identify strategies that maximize a person’s energy and strength, such as working out at certain times of the day
Occupational therapy can be very effective. A 2016 case report details the story of a middle-aged woman with MS who sought hospital treatment for MS, including occupational therapy.
At first she needed significant help with most daily activities, but after 8 days of treatment she had largely achieved her independence.
On a seven-point independence scale, she had a 4 in feeding and grooming at the start of treatment and a 7 at the end.
She also reported significant improvements in her satisfaction with her ability to perform all of the major life activities that the assessment measured.
Everyone’s treatment plan is different and not all occupational therapists are right for everyone with MS.
Before meeting with an occupational therapist, it is advisable to take the following steps:
- List the areas in which MS has affected daily life or performance.
- Make a list of all the current symptoms of MS.
- Identify the most important daily tasks and list the obstacles to achieving them.
When the person meets with an occupational therapist to discuss the above, the therapist will understand the tasks to be prioritized.
For example, people in paid jobs may prioritize pursuing these tasks and then developing the skills needed for volunteer work or leisure activities.
Unlike traditional exercise or physiotherapy, occupational therapy aims to help a person achieve specific goals, such as getting to work or sitting in a chair without pain.
There is no single occupational therapy plan and each person’s exercise regimen will vary. Treatment plans can change over time, depending on the person’s changing priorities and the progress of the disease.
These exercises give a general idea of what to expect from occupational therapy for MS, but a person should discuss their symptoms and goals with an occupational therapist before trying them at home:
Improve physical function
Strengthening exercises focus on recovering or maintaining strength in specific areas of the body.
The right combination of exercises will vary depending on a person’s needs. Some options to try include:
- Sit in a neutral position on a chair with your feet flat on the floor. Raise one arm towards the ceiling, the hand extended outward. Lower it and repeat on the other side. Repeat several times.
- Sit in a neutral position on a chair with your feet flat on the floor. Place the hands next to each other on a weight (or can of soup) so that both hands are supporting the weight. Slowly raise the hands above the head until the weight points towards the ceiling. Repeat several times.
- Practice wrist control while sitting in a chair with your feet flat on the floor. Hold an object in one hand with the palm facing down. Next, place the forearm flat on a table or desk and keep it still while lifting the wrist up and down several times. Repeat on the other side.
- Start on all fours on the floor. Lift one arm and hold it straight in front of the face for a few seconds. Repeat with the other arm. Then repeat the process with the legs, lifting each leg directly behind the body until it lines up with the back.
- Stand up straight on a stable surface. Lift one leg out to the side, keeping it straight but not locked. Repeat on the other side. Do several repetitions.
Pelvic floor exercises
Many people with MS suffer from incontinence. Pelvic floor strengthening exercises can help a person become more aware of the need to use the bathroom and they can improve symptoms of incontinence. A person can try the following:
- Sit on a chair or lie on the floor. Keeping the knees bent and the spine neutral, move the knees side to side for 1 to 2 minutes.
- Lie down on the floor. Bend your knees and keep your feet flat on the floor. Push down through the legs and use the core to lift the pelvis off the ground, then lower it. Repeat several times.
- Start on the floor on all fours and contract your abdominal muscles to pull the belly button up and arch your back. Then hollow out the lower back by lowering the stomach and slightly arching the upper back. Repeat this series of movements several times to improve core and pelvic floor strength.
Use assistive devices
Wheelchairs, canes, shower support bars, and other assistive devices can promote smoother movements, prevent falls, and compensate for loss of mobility.
They also require skill and practice to master them. In some cases, a person may need to build strength in specific areas of the body to use these devices. A person may want to ask an occupational therapist to help them choose and use:
- a shower seat or a shower bar
- a walker walking upright
- a wheelchair
- hearing aids
Adapt movements and activities on a daily basis
It is not always possible for a person to perform tasks and activities in the same way that they always did before. Indeed, trying to do so can make life with MS more difficult.
An occupational therapist can help a person adjust their usual movements and activities to changes in their body. Some easy ways to change daily activities include:
- sit down while dressing
- lower the clothes bar in the closet
- use the elbows to help support the body while eating
- using two hands to hold a glass
- turn down the water heater to avoid dangerously hot shower water
- invest in comfortable chairs throughout the house and sit on them to do activities such as cooking
- drag or push objects rather than lifting them
- using supportive devices, such as an electric can opener, shoehorn, bedside toilet, and velcro shoe closures
Most people need to take MS medication. These drugs, which doctors call disease modifying agents, can slow the progression of MS by reducing inflammation in the immune system.
Some people take more than one medicine at the same time. Most will need to adjust their specific medication over time in response to side effects and disease progression.
Some other treatment options include:
- physical therapy
- speech therapy
- pelvic floor physiotherapy
- treat any underlying disease process that worsens the effects of MS
- lifestyle changes, such as quitting smoking
- medications, such as corticosteroids
- psychotherapy and support groups to help a person maximize their quality of life with MS
MS is a chronic disease. For many people, it is also progressive, which means that it gets worse over time. However, some people may experience periods when their symptoms improve temporarily.
There is no cure for MS, but treatment can help slow the progression of the disease and relieve symptoms. Some people go into remission with the right treatment, which means they don’t have any symptoms.
Research suggests that the life expectancy of people with MS is only slightly shorter than that of the general population. However, the authors note that people with MS have higher death rates due to infectious diseases and diseases of the respiratory system.
Occupational therapy provides a way for a person to identify treatment goals specific to their life, values and needs.
This customizable approach can help a person live better, feel more independent, and reduce their risk of injury.
A person with MS may ask a doctor for a referral to an occupational therapist. When discussing a treatment plan with the therapist, they should be honest and specific about their goals.