I am a physio working in a community rehab unit which those with MS attend
for short bursts of rehab on an inpatient basis ( thus eliminating the
fatigue associated with travelling ). Between admissions therapy is then put
into context by use of home visits, liason with carers, visits to places of
work or resource centres etc as appropriate.
This predominantly inpatient system seems to work as those with MS can focus
on themselves without the peripheral clutter of being at home - a kind of
"health farm approach". From the neurophysio perspective, greater inroads
can be made into changing movement patterns, moulding/ altering compensatory
strategies etc. without fearing that the patient will be unable to function
at the end of an hour's therapy session so that over the course of a two
week admission, real gains in functional strength can be made as patients
can work out to levels of fatigue they would not dare to in their own home
environment.
Also changes in medication can be made & monitored closely e.g anti-spasm
medication, as well as other issues such as nutrition & continence being
tackled by other members of the mdt.
Seems to work well but how do I turn this into a research protocol - any
thoughts anyone?
Two further questions to throw out to the wisdom of the list.........
1) Is improving ability following rehab. input in a person with progressive
MS due to neuroplasticity in the CNS or due to changes in the
musculoskeletal system?
2) When specifically stretching tight spastic muscle ( in order to affect
the non-neural components of spasticity, as opposed to trying to inhibit the
increased tone ), what is allowing gains to the muscle length ? I mean at a
structural level?
Debbie Neal ( physio, UK )
> From: Jo Semlyen <[log in to unmask]>
> Reply-To: [log in to unmask]
> Date: Tue, 17 Oct 2000 08:13:28 +0100
> To: "[log in to unmask]" <[log in to unmask]>
> Subject: Physiotherapy and Multiple Sclerosis
>
>
> May I open a debate and invite interest, knowledge and opinion on the
> question of the benefit of Physiotherapy in Multiple Sclerosis.
> I would like to invite interested, opinionated and knowledgable people to
> come forward to me at the MS Society as we strive to unravel and understand
> and subsequently contribute to the evidence base surrounding this area.
> Please email me directly. I would like to invite sources of evidence,
> current opinion, clinical experience and research activity.
> Many thanks.
>
> Jo Semlyen
> Applied Research Liaison Officer
> Multiple Sclerosis Society
> MS National Centre, 372 Edgware Road,
> London, NW2 6ND
> Tel 020 8438 0700
> Fax 020 8438 0701
> email [log in to unmask]
>
>
>
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