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        The symptoms associated with MS vary between one person and another, 
          both in the areas of the body affected and the degree of severity. The 
          aim of physiotherapy is to improve the individual’s functional 
          abilities in order to maximise their independence and to reduce disability. 
        
          How 
          can physiotherapy work?
How 
          can physiotherapy work?
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        Physiotherapy can help in the following ways 
        General advice on a variety of subjects such as posture, 
          how to avoid back problems, transfers e.g. how best to transfer in and 
          out of a car. 
        Specific exercises. These are exercises that are designed 
          to help a particular problem. Some examples are:- 
      
       
        Hydrotherapy- exercise in water. Water is an excellent 
          medium in which to exercise as the water helps to counter the weight 
          of the body making movement and exercise easier.
          
          Prevention. Physiotherapy may be useful in preventing 
          problems occurring. For example where there is muscle weakness and reduced 
          movement it is important to stretch the relevant muscles to prevent 
          them from shortening as this would gradually result in joint stiffness 
          leading to pain and immobility. There are exercises that a person can 
          do for themselves or someone can do for them to stretch the affected 
          muscles. Another example of prevention is improving posture to help 
          reduce the occurrence of back problems and stiffness. 
          Walking aids. The provision of walking aids e.g. walking stick, is an 
          important area and there are various considerations such as which aid 
          is most appropriate and is the aid the correct height for the individual. 
          The physiotherapist would demonstrate how the aid should be used correctly 
          and safely. 
        Advice to family and carers. The sort of advice that 
          may be helpful is how best to help people move/ transfer (e.g. around 
          the house, in and out of the car), how to look after their own back 
          to avoid injury, demonstration of the exercises and explanation of how 
          they are helpful. 
         What 
          does the physiotherapist do?
What 
          does the physiotherapist do?
        
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         Assessment
         The first step in any physiotherapy treatment is assessment. The physiotherapist 
          would be looking at such symptoms as muscle weakness, changes in sensation, 
          balance problems etc. and would then take into consideration other factors 
          such as lifestyle, fatigue, and personal needs in order to decide what 
          physiotherapy treatment might be most appropriate and helpful. 
        Advice and Exercise
         The physiotherapist would then give advice and suggest appropriate 
          exercise for the individual. The exercises would be practised during 
          the physiotherapy session and usually accompanied by suitable exercises 
          that may be practised at home. 
        Follow-up
         The physiotherapist would continue to see the person over a period 
          of time to assess progress and alter treatment as required. They would 
          also be able to refer the person to other departments as necessary. 
          e.g. Occupational Therapy, Specialist Nurse, Orthotic Department. 
         How do you arrange physiotherapy?
          Where can you receive physiotherapy?
      
       
        Nos 1-3, Via GP for the hospital and community services 
        Nos 4-5, By self-referral for MS Therapy centres and private practices. 
        
        The physiotherapy services provided by the NHS vary from area to area 
          as do the other services. The therapy centres are at various sites around 
          the country. Further information about the centres may be obtained from 
          the Who Can Help’ leaflet available from this unit. Some hospitals 
          also have rehabilitation centres. The physiotherapy department at your 
          local hospital would be able to advise you of facilities in your area. 
          If you seek therapy from a private practitioner ensure that they are 
          a Chartered Physiotherapist as are all NHS physiotherapists and that 
          they are experienced in the treatment of neurological conditions.
          
          This is an outline of physiotherapy and how it can help people with 
          MS. The information and examples given may not be suitable for everyone 
          and you should consult a physiotherapist for specific advice and treatment.