physical activity should talk to a healthcare provider
first about safety limitations.
People with MS often have trouble with heat,
and some people avoid physical activity because
it increases body temperature, and can exacerbate
symptoms. When this happens, it’s common to
think the disease is getting worse. But actually it’s
just the symptoms, which go away once a person
cools down.
I sometimes recommend aquatic exercises or
resistance exercises with weights because they
don’t increase the body temperature as much as,
say, running. People can also try activities that can
increase balance, such as yoga or just stretching on
a mat.
Biking can be a good idea because it doesn’t
increase body temperature as much as running does.
Not only that, it’s easier on your knees.
Are there any promising new
medications for gait?
Ampyra, which was approved by the Food and
Baclofen or tizanidine can improve muscle
tone and improve walking in some people with
spasticity. Some people may consider having a
baclofen pump surgically implanted to deliver
medication straight to the spinal cord and reduce
the amount of medication needed. The pump needs
to be refilled every six months or possibly sooner,
depending on the dose and rate of infusion. But it
tends to result in fewer side effects than oral anti-
spasticity medications, which can cause drowsiness
or dizziness. This is because a person can receive the
same beneficial effect at a far lower dose by pump
than by mouth.
In some instances, Botox injections may be used
to reduce or eliminate the spasticity of a specific
muscle group in any limb. It can improve the
functional use of the limb and reduce the risk of
developing contractures (the permanent shortening
or stiffening of muscles). However, doctors can’t
control the degree of weakness or paralysis the
injection may induce. It also takes a week to see the
benefit and the effects wear off after three to five
months.
What kind of MS research have you been
doing?
We have been doing quite a bit with a
NeuroCom balance machine. It’s a platform
with sensors underneath that detect sway when a
person is walking on it. Often, swaying is kind of
hard to see if the person just walks up and down
a hallway during an exam. But we’re actually
getting numerical data when we put someone on
the platform. It not only detects the sway, but
it also delivers information about stride length,
step length, foot angle, step time (how fast you’re
walking) and swing time (how long your leg is in
the air during a step).
Q: A:
Is there anything else people with gait
problems should keep in mind?
It’s important to get active early on in the disease
process to minimize long-term disability. But
to do that, a person needs to have sufficient muscle
strength and balance. Work with your healthcare
team to find the safest, most effective way for you to
develop those assets—and get moving. ;
Q: A:
Laura Putre is a Cleveland-based writer whose work appears
in health-related publications.
Additional resources
The National MS Society’s Free from Falls
program includes a DVD and booklet that may
be useful in reducing falls and improving gait. To
order, call 1-800-344-4867 and select option 1.
