“Sticking to the holistic management of MS theme; have you had a recent bone health assessment by your family doctor, or GP, or your neurology team? The meta-analysis below (combining many trial results into one) show that MSers are at increased risks of bone fractures. This is not new. For those of us who spend our time treating MS we see a large number of MSers with fractures every year. Why is this issue important? Mainly because it is common trigger for moving into a wheelchair. In an audit done at our hospital the best predictor of falls (the main cause of fractures in MSers) was use of a walking aid. Once someone with a walking aid falls and fractures a long bone on the lower limb (femur, tibia or fibula), by the time they have recovered from being incapacitated by the fracture they are often dependent, or at least partially dependent, on a wheelchair for mobility. Falling and sustaining a fracture also seriously knocks one confidence about getting out and ‘doing it’. I have seen too many MSers after a fracture become housebound because of falling again and sustaining another fracture. Therefore it is very important to try and anticipate falls and fractures so they can be prevented. Our neurophysiotherapists run a falls prevention clinic; so if you are concerned about falls please ask to be referred to a physiotherapist for an assessment.
- mopping up spillages straight away
- removing clutter, trailing wires and frayed carpet
- using non-slip mats and rugs
- using high-wattage light bulbs in lamps and torches so you can see clearly
- organising your home so that climbing, stretching and bending are kept to a minimum, and to avoid bumping into things
- getting help to do things that you are unable to do safely on your own
- not walking on slippery floors in socks or tights
- not wearing loose-fitting, trailing clothes that might trip you up
- wearing well-fitting shoes that are in good condition and support the ankle
- taking care of your feet by trimming toenails regularly, using moisturiser and seeing a GP or chiropodist about any foot problems
- Doing regular exercises to improve your strength and balance can help reduce your risk of having a fall. This can range from simple activities such as walking and dancing to specialist training programmes. There is also evidence that taking part in regular tai chi sessions can help reduce the risk of falls in the elderly; I am sure this would work for MSers. Tai chi works by improving balance and co-ordination.
- Drugs that increase sedation increase your risk of falls.
- In addition to poor balance and abnormal postural righting reflexes poor vision increases your risk of having a fall. If you have visual problems you may need to been seen by an eye clinic to see if anything can be done to improve vision.
Alcohol:
- Drinking alcohol exacerbates MS-related inco-ordination and exaggerate the effects of sedatives. A large number of MSers drink excessively. Please try and not drink alcohol, or at least reduce your consumption. If you have an alcohol dependency problem ask for help.
Su et al. The association between multiple sclerosis and fracture risk. Int J Clin Exp Med. 2014 Nov 15;7(11):4327-31. eCollection 2014.
Background: Several studies were performed to assess the association between multiple sclerosis (MS) and fracture risk. However, the results were inconsistent and inconclusive.
CoI: multiple
On a lighter note, a friend commented on the fact that I have just renewed the fitted carpet in my bathroom/toilet. 'Nobody goes for carpet in the bathroom any more – tiles would look much nicer, and you can get them non-slip now'. Yes, you can, but no hard floor covering is going to be non-slip when it's splashed with water. Eleven years with MS = one broken arm/two snapped finger tendons/one sprained ankle/one back injury. I'll go with the off-trend bathroom, thank you.
Anon 10:15 am. Nothing like common sense ruling the day! I hope you have your bone density done; if not please speak to your GP or MS nurse. Ditto for vD.
Surprised that there is no mention of a rollator. I can walk and I do need an aid otherwise I fall over 🙁 . Rollators are ideal for me, they provide support, seat if tired and basket to put things in. Rollators are sending out a positive message plus with them you are getting exercise. I am not keen on wheelchairs, they do not put out a positive message however I do accept that for some people there is no alternative.