Multiple Sclerosis (MS) is a chronic, progressive disease where the immune system mistakenly attacks the myelin sheath, the protective covering of nerve fibers in the central nervous system (CNS). This damage disrupts communication between the brain and the body, causing unpredictable neurological symptoms. Occupational Therapy (OT) helps people participate in the activities of daily life, or “occupations,” that they need to perform. For individuals with MS, OT provides tailored strategies to maintain functional abilities, promote independence, and enhance quality of life. Therapists assess how MS symptoms, such as fatigue, muscle weakness, and cognitive changes, interfere with daily tasks, and then implement personalized intervention plans.
Strategies for Energy Conservation and Fatigue Management
Chronic fatigue is one of the most common symptoms of MS. Occupational therapists address this by conducting a detailed assessment of a person’s daily routine to map out energy expenditure. This evaluation identifies which activities are the most taxing and when peak fatigue occurs.
A core concept taught by OT is the “energy envelope,” helping clients live within their limited daily energy reserves. Therapists guide patients in activity pacing, balancing activity periods with scheduled rest breaks before tiredness begins. They also teach task prioritization and work simplification, such as delegating chores or breaking down complex tasks into smaller, manageable steps. Organizing workspaces and setting up “rest stations” strategically around the home allows for energy-saving transitions.
Adaptive Techniques for Daily Living
When motor function is impaired by symptoms like muscle weakness, tremor, or poor coordination, OT introduces adaptive techniques and assistive technology to ensure independence. These interventions focus on Activities of Daily Living (ADLs), such as self-care, and Instrumental Activities of Daily Living (IADLs), including household tasks. For dressing, therapists may recommend low-tech devices like dressing sticks, sock aids, or button hooks. Weighted utensils can be used to counteract hand tremors during eating, providing greater stability and control. In the kitchen, adaptive tools and methods help with meal preparation, such as electric jar openers, non-slip mats, or long-handled tools to reduce bending and reaching.
Addressing Cognitive and Sensory Changes
Multiple sclerosis can affect non-motor functions, including cognitive changes often described as “cog fog,” involving impairments in attention, memory, and processing speed. Occupational therapy provides targeted cognitive rehabilitation focusing on teaching compensatory strategies rather than solely attempting to restore lost function. Therapists help clients implement external memory aids to offload the cognitive burden of remembering and organizing:
- Structured planners
- Daily checklists
- Smartphone reminders
- Strategically placed visual cues like labels
Task simplification is also used, where complex activities are broken down into fewer steps to prevent overwhelm and reduce the demand on working memory.
Sensory deficits, such as numbness, tingling, or visual disturbances, are addressed through environmental modifications and specific training. For example, a person with reduced sensation in their hands might be taught to visually check water temperature before bathing to prevent burns. To compensate for visual issues, therapists may recommend using contrasting colors on stairs or near grab bars to improve depth perception and reduce the risk of falling.
Home and Workplace Environmental Modifications
Occupational therapy assesses and recommends physical changes to living and working environments to enhance accessibility and safety. These modifications often involve structural alterations distinct from portable assistive devices. In the home, common recommendations include installing grab bars in the bathroom, modifying access with a walk-in shower or tub transfer bench, and adjusting the height of seating to reduce effort during transfers. For individuals working, OTs assess the ergonomic setup to minimize physical strain, ensuring correct desk height, chair support, and monitor placement. Proper lighting is another modification that compensates for visual changes and contributes to a safer environment.