By Lorraine H. De Souza MSc, MCSP Grad, Dip, Phys. (auth.)
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Additional resources for Multiple Sclerosis: Approaches to Management
Situations such as an acute relapse call for the physiotherapist to implement maintenance regimens which are often passive in nature. A supportive approach in such situations can help to dispel patients' fears that the physiotherapist is only interested in them when they are well, and does not offer help or contact when they get worse. People with MS will often seek advice from the physiotherapist on many subjects, while therapists will give advice to patients both formally and informally. In assuming an advisory role the physiotherapist should be quite clear what constitutes professional advice for which she has training and clinica!
Assessment in both static postures and during movement should be carried out as part of the clinica! evaluation. Maintaining equilibrium relies not only on the functional integrity of the vestibular apparatus, but also on sensory input from proprioceptors and pressure receptors. Therefore a sensory assessment may be necessary. The emphasis of treatment should be to encourage movements and functional activities, such as transfers, which will facilitate and stimulate balance reactions. Motor control of the head and trunk is the key to maintaining stability in both static postures and during movement.
1983) Need for and use of social and health services by MS patients living at home in England. Lancet, i, 8339; 1091-3. L. (1980) Multiple sclerosis management and rehabilitation. International Rehabilitation Medicine, 2, 116-25. R. et al. (eds) (1985) McAlpine 's Multiple Sclerosis. Churchill Livingstone, London. J. (1983) Social Work With Disabled People. Macmillan, London. Robinson, I. (1987) Productive partnership? C. Rose and R. Jones). John Libbey Publications, London, pp. 245-53. , Larocca, N.