ALERT Mobilit y
The role of drugs or
surgery
by Emily Wojcik
What’s the doctor got to keep people
moving should mobility decline?
“MS can affect a person’s ability to walk in a num-
ber of ways,” said Adrienne Boissy, MD, of the
Cleveland Clinic Mellen Center for MS. “Weak-
ness. Coordination. And spasticity.”
“Weakness can be associated with spasticity or
can show up on its own. One or both sides of the
body may be involved,” she continued. “Some
people have weakness primarily affecting a foot and
may only notice ‘foot drop’ when they hear their
foot dragging on the ground. Others may have leg
weakness, which makes it difficult to stand up from
sitting or to climb stairs. Weakness can also mani-
fest as fatigue after walking for some distance.”
COURTESY OF THE CLEVELAND CLINIC’S MELLEN CENTER FOR MS TREATMENT AND RESEARCH
Walking involves both coordination and bal-
ance. “People may feel like they’re intoxicated when
they’re not, or they have to walk with a wide-based
gait,” Dr. Boissy said. “The ability to walk is so
ingrained we don’t have to think about how com-
plex the movements are. However, if a person’s
balance centers are affected by MS, walking will
require a great deal of conscious effort.”
Spasticity manifests as stiffness, charley horses, or
abnormal posturing of a limb, foot, or hand. It may
be mild or extremely painful—and up to 60% of
people with MS have this symptom.
Physical therapy and assistive devices
Regardless of the cause, when mobility declines the
best first step is often physical therapy (PT). “At our
clinic we rely heavily on PT to help assess mobility
issues,” Dr. Boissy said. “If fatigue is a part of it, the
therapist can offer techniques for energy conserva-
