Mobility with MS
Mobility is defined as our ability to move based on our own muscle power, coordination, balance and resistance. When our own ability to move deteriorates, it can be supported with the use of outside aids (grab rails, canes, walkers, wheelchairs…).
On many occasions the constraints on movement can affect daily activities and, depending on their severity, can result in a loss of independence.
A series of devices that can help increase your mobility are listed below:
Depending on the progression of the disease, the use of aid devices like canes, crutches, walkers and/or wheelchairs may be needed to help with walking. Medical equipment is available to help you.
When there are balance problems, weakness, spasticity or fatigue, the use of one or two crutches can help you walk more safely on your own. The use of crutches, in addition to helping you walk and reduce the risk of falls, will allow you to do a certain amount of exercise. Exercise will help you reduce the frequency of symptoms like spasticity and fatigue.
In some cases, when balance or weakness problems are more severe, the use of a walker may be recommended in order to provide you with more stability. The use of a walker with two front wheels is preferred.
On the other hand, either with or even without these aids, you may be able to handle short distances well, but have problems with longer distances, or when you are away from home for long periods of time. In these cases, it is best to have a wheelchair that you can use when needed (however, you will have to determine whether an electric or manual wheelchair is best for you).
Driving with MS
Advances in current technologies and industry now mean that a diagnosis of MS no longer means that you are automatically incapable of driving a motor vehicle.
So that MS patients can drive and if their healthcare professionals agree, certain modifications and/or adaptations to the vehicle may be needed, depending on the situation. These must make up for any disabilities and allow patients to drive safely.
When applicable, these modifications or adaptations must be officially certified and can only be performed by specialized shops and personnel. Vehicles may come with modifications and/or series adaptations or these can be made before or after registering the vehicle in most countries. Vehicles must pass the Vehicle Technical Inspection (VTI) to ensure that they meet current regulations regarding certification and security. These adaptations are performed by professionals at authorized medical centers who review driver’s licenses. Please check your country regulations and consult the appropriate experts.
Depending on the country, vehicle and the type of disability in question, there are different possibilities:
- In order to drive a vehicle:
– An easier-to-use steering wheel and/or adapted braking system that compensates for a lack of strength.
– Mechanical manual controls that allow the accelerator and brakes to be operated using the upper limbs.
– Power-assist brakes and accelerators can compensate for a lack of strength and control in the arms.
- If you drive a van, there are vehicles available that have lowered floors and are equipped with ramps or small lifts. A series of adaptations might allow you to access the driver’s seat, or even drive from a wheelchair.
When it comes time to drive, there are a series of recommendations you should follow:
- If you are experiencing intermittent double vision, do not drive.
- If you are experiencing photosensitivity, sunglasses may help.
- You may be able to compensate for a loss of peripheral vision by using special mirrors.
- Severe visual disturbances may make driving in general impossible, or may only affect night driving.
- You should not drive if you are experiencing drowsiness or just before or after taking your medications.
- Talk to your doctor if the medications you are taking may make it impossible for you to drive.
If you have MS, in order to obtain your driver’s license certification, depending on the country you might have to follow the steps below:
- Undergo specific tests at a medical center. You might have to go to a Driver’s Medical Examination Center where, after undergoing a series of tests, they will evaluate, diagnose and advise you regarding any adaptations you will need and will give you the corresponding technical report.
- Modify your vehicle: you might have to go to a specialized shop to have your vehicle adapted to your needs.
- Obtain vehicle technical approval: after your vehicle has been modified, it might have to pass the Vehicle Technical Inspection (VTI).
- Renew your driver’s license: You might be subjected to a greater number of examinations than for the standard driver’s license and you might have to submit the report issued by the Driver’s Medical Examination Center, your driver’s license, photographs, and a copy of your fiscal ID document to the corresponding Provincial Traffic Police Headquarters. After this, your driver’s license will include information on the limitations you were experiencing at the time and the adaptations required for driving.
- Take a road test: Depending on your condition status and country regulation, the corresponding Provincial Traffic Police Headquarters can require you to pass a road test. The test will be conducted by an examiner from the Headquarters and a physician. After this test, the corresponding adaptations will be established.
1. US National Multiple Sclerosis Society: http://www.nationalmssociety.org/
2. Drs. M. Murie and E. Moral (2011): Espasticidad en Esclerosis Múltiple, ISBN: 978-84-15198-27-7, Luzán 5, S.A., Madrid, Spain