Rehabilitation: Its role in multiple sclerosis

When a multiple sclerosis (MS) patients walk into a specialist’s office, they do not say, “Doctor, please help me. My T-cells are attacking my myelin.” Rather, they are more likely to ask for help with a foot-drop, weakness, memory or bladder problems, pain, or state that things are not going well at work. Thus, at the outset, MS patients ask for help with their functional impairments or disabilities. They are asking for rehabilitative services (1). Rehabilitation is still the only way to improve function in MS (2). A patient can be improved from bed-bound status by giving her a wheelchair [from an Expanded Disability Status Scale (EDSS) of 8.0 to 7.0] and from wheelchair reliant (we must stop using the pejorative term “wheelchair bound”) to ambulatory with an orthosis or walker (from 7.0 to 6.5).