Peter: So how can a neuro-physiotherapist help people with MS?
Nicola Hatton, Neurological Physiotherapist: I think the main thing is that we have a deeper understanding of the central nervous system and how the pathology of MS impacts on that person’s system. We’ve got an understanding of how the body and how the brain kind of recovers after perhaps a relapse or how it over time changes to accommodate the problems that you have. So the physiotherapy is kind of directed along a systems based approach in terms of what problems do you have, is it a problem with sensation, muscle function, power, balance, co-ordination, vision, lots of different things that we will look at as separate issues and then put all together to try and establish where we need to start with the treatment.
And again, we want to help you manage your own condition, so we’re not always doing lots of hands-on treatment, a lot of it is based on advice and sending you away with information, exercises to do, just trying to encourage you in general to be as active as you can be, based on the assessment initially. So yeah, it’s having that sort of assessment and being seen over a period of time so that we know what we can change and what we can’t change, and that’s very valid information to give to a patient so that you know where to focus your energy and just having somebody say well, if you go away and do this, we think we might be able to create an improvement, or, unfortunately, the damage has happened here, that may not change, we’ve got to find ways of helping you manage that. So it’s like a dual sort of approach really.
Peter: Is what you would do, is the treatment different for different types of MS? You know, you’ve got recurring remitting – or whatever you call it, gets called different things – and progressive and secondary progressive as well.
Nicola Hatton: Yeah, I would say for every patient you pretty much do something slightly different anyway regardless of whether it’s remitting relapsing, primary or secondary progressive, depending on what symptoms they’re presenting with. Obviously, it’s useful to know the actual course of the disease because that allows you to establish what is potentially achievable, so whether you’re looking at bouncing back after a relapse or whether you’re looking at accommodating yourself to a new set of circumstances. And yeah, there’s quite a lot of factors that go into that and preferably, we have a good system here where if I’m your physio, you would have known me for years quite often. So it’s always useful to have the same kind of therapist if you can, or that continuity so that we can kind of discuss with you whether we think perhaps you’re going into a secondary phase or whether we think this is a relapse or not a relapse. And it’s really tricky sometimes, knowing whether you are having a relapse or not.
So having somebody who knows you quite well and knows how your body tends to be can be quite useful in determining whether you need to go off to the doctor’s or you need some steroids or you need to just think, no, I’ve got to ride this out, it’s not a relapse, I’m just having a play up, or I’ve had a virus, or there’s other things that have gone on that are causing a deterioration at that time. But I appreciate that not everywhere has that kind of system and that’s where really as the patient or the person with MS, we need to try and help you understand what your symptoms are, what they are caused by and trying to – it’s a bit of a cliché – sort the wood out from the trees, because particularly in the early stages it’s really hard to know, the symptoms you’ve got, are they MS related. There’s many other things it can be due to and sometimes just talking that through with somebody, not necessarily your physio, it could be your GP, MS nurse, somebody like that, that can kind of help you work out what’s what, can be really useful.
Peter: Thank you.
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