Occupational therapy for Multiple Sclerosis

Overview
Occupational therapy is focused on maintaining and improving the ability to engage in daily activities, whether self-care, paid work or leisure pursuits. An occupational therapist can help people with multiple sclerosis (MS) preserve quality of life by finding ways to work around disabilities, teaching energy conservation strategies, and providing counseling. Since MS symptoms and disabilities vary between individuals, your therapist will carefully tailor a program to your specific challenges and goals.

Fatigue and physical disability lead many people with MS to curtail their activities and become increasingly sedentary and isolated. However, by addressing the physical, cognitive and emotional challenges that people with MS face, occupational therapy can make it easier to stay independent, active and engaged in their lives.

What does it involve?
Depending on what state you live in and what type of insurance you have, you may require a referral from your doctor in order to see an occupational therapist. Occupational therapists may have private practices or work at clinics, schools, skilled nursing facilities or home care agencies.

At your first occupational therapy session, the therapist will ask you detailed questions about the activities with which you are having trouble. They will identify personal factors such as your MS symptoms, physical condition, cognitive issues such as memory, and emotional health; environmental factors such as assistive devices and social support networks; and occupational factors such as the demands and timing of the tasks on which you want to focus. In addition, they might perform tests to evaluate your range of motion, muscle strength, fatigue levels, or neuropsychological functions.

Using all of this information, the occupational therapist will set goals for your therapy. Goals might be finding ways to compensate for disability, preventing injury, or regaining or retaining abilities. Specific examples of occupational therapy interventions include making adjustments to your work or home environments to allow for easier movement or vision; learning to set reminders on your phone if you have trouble remembering tasks; learning new ways to perform tasks such as bathing, dressing, or preparing meals; or learning how to choose and use assistive devices such as wheelchairs.

Some occupational therapists specialize in certain areas such as cognitive rehabilitation, driving, or returning to work.

Intended Outcomes
The goal of occupational therapy in general is to keep people engaged in meaningful, productive activities despite the challenges they face.

Results
One retrospective study in 2010 examined the outcomes of people with MS over five years who received occupational therapy at an inpatient rehabilitation center. The Functional Independence Measure (FIM) score of those who received occupational therapy during their stay were significantly improved between admission and discharge. Occupational therapy interventions were found to help most with cognitive rehabilitation, reintegration into the community and self-care.

Constraints
Most types of insurance will only pay for a limited number of occupational therapy appointments.