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Although disease-modifying treatments may slow disease progression, people living with MS may experience functional limitations from relapses and disease progression. Rehabilitation in MS involves strategies to improve or maintain function, prevent complications and enhance overall quality of life. Rehabilitation may be needed at various points in the disease course to help the person maintain and/or recover a higher level of physical, cognitive and vocational functioning.

MS complications (contractures, disuse atrophy, pressure sores, risk of falls, increased dependence) can be reduced or prevented by rehabilitation interventions. Assessment for rehabilitation services should be considered early in the disease when changes may be easier to implement, including individuals who are newly diagnosed and present with any functional limitation. Healthcare providers should also consider referring a person for a rehabilitation assessment when there is worsening of function or impairment that impacts mobility, safety and independence. Individuals should also be assessed for durable medical equipment needs and occupational and environmental modifications.

Rehabilitation in MS comprehensive care

Rehabilitation interventions should be patient-centered and used with other medical interventions to address MS symptoms that impact ADLs, speech, mood disorders and cognition. Communication between the referring healthcare provider, rehab professionals and other members of the healthcare team will facilitate high quality, comprehensive care. The MS rehabilitation team includes a number of specialty areas physical therapy, occupational therapy, speech language pathology, neuropsychology, driver rehabilitation. vocational rehabilitation and vision rehabilitation. Rehabilitation specialists may work closely with a registered dietician if a patient has issues with swallowing or fatigue-related weight-loss. The person at the center of the care team and referral point to rehabilitation may be another healthcare provider or a social worker. Rehabilitation specialists who make home visits may notice patients need additional resources – if a patient has a social worker, that individual can assist with providing more information and support.
Whenever possible, patients should be evaluated and treated by therapists who are familiar with neurological degenerative disorders. In physical therapy, MS treatment by a neurologic certified specialist is preferred over an orthopedic certified specialist.

Reviewed by Sue Kushner, PT, MS, Diane Meyer, PT, MSCS and Brian Hutchinson, PT, MSCS, February 2021

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