Physical Therapy Long-Term

[essdipity]

Good morning to everyone who's awake on a rainy Saturday. I hope it's lovely where you are, be it Florida, Canada or Australia. (And all points between, natch.)

My question is about on-going PT. My own situation is that I've had 6 weeks of it, twice a week, and have shown improvement, in balance especially. My insurance is excellent and not a factor here. It could allow me to continue PT almost indefinitely, with the proviso that I think all insurance makes---that improvements be shown.

I like my physical therapist a great deal and I know her only motive is to help me. She isn't looking at me as a steady source of income, and there are loads of other patients anyway. But still, I'd like to think this thing has a beginning, a middle and an end. She works me hard for more than an hour each time. I often go home exhausted, with achiness that lasts for days. She lets up on me somewhat when I tell her I'm especially tired, and she knows that I do other exercise programs to help myself. These can be a bit tough too, but I've never felt exhausted from them, just PT.

I had an all-over strength and balance assessment at the beginning, and another after a month. As I said, my balance has improved significantly. No muscles show decreased strength, a few groups show slight improvement, and others stay the same. These last are the ones where weakness is attributed to MS, although in a sense she attributes all less that *5* scores as MS weakness. I know nothing about this part.

I gather from others here maintaining strength is the goal. I'm certainly doing that at this point. But I'm also getting tired of this open-ended PT schedule. I'd rather not be so tired, and I'd rather have that time for other things. In any case I'll still do my other physical activities and exercises. I'm not a couch potato.

I'd love to hear from the kind PTs who belong here, and also from other members who are having PT, or used to. Would it be reasonable to take a month off? Would it be reasonable to just stop, with the understanding that I can come back if necessary? Am I being foolish? Your comments most welcome.

ess

[Quixotic1]

You bring up a good point.  Physical Therapy is a cornerstone of MS treatment, but it is intended to be a now and again thing.  Most people reach their benefit and stop formal therapy with periodic reassessments.

I'm concerned that your PT is as punishing as it is.  She seems a bit undereducated on the fine line between slowly building strength and the possibility of actually doing damage to muscles with damaged motor nerves.  You should not be suffering more than 24 hours from your sessions.

When you push too hard you actually backslide some.  This is not good - for your QO or your muscles.  We should try to find some stuff from the official literature on PT, goals and cautions.  If we can find something very clear, you should give it too her.

I think it would be more than reasonable to take a month off.  You can continue some of the work at home to maintain the gained strength.  Then you can see how you are doing.

I'm actually surprised at an open-ended plan.  PT is goal-driven generally.

Quix

[shoshin]

When I went to PT, the first day the PT did an assessment and set up some goals. Then she said they wanted me to come twice a week for four weeks. On the last day, the PT retested a lot of stuff and recorded my progress (or non-progress in some areas). She gave me a bunch of printouts of exercises to continue doing at home. I was told to come back if my situation changed or if I needed a refresher.

I don't know if that's typical or has anything to do with how much my insurance covers, but I certainly couldn't have kept going twice a week indefinitely. I can't get that much time off work and it took a lot out of me, too. I would think that if you're capable of exercising on your own (without the PT or the equipment) then there would come a time when you would max out on the benefit of going there.

sho

[Lulu54]

dear Ess,
a quick look at your question through other PT websites makes this repeated point - lengths of PT vary.  You should not fixate on the amount of time, but rather set realistic goals of what you want PT to accomplish for you. .

Work toward those goals, especially with a home program that augments what you do with the therapist.  When you feel comfortable, I would certainly taper back on the number of in person sessions, but leave open the option of resuming a more rigorous schedule if your symptoms need it.  

You are fortunate the insurance is not a question for this help.  Mine will cover PT, but each visit is a separate co-pay.  If I were to go three times a week, that is 3 copays.  Our cardiac rehab program is the same way.  This can add up to quite the expense in a  very short time.  

Lu

[rendean]

I have the exact same situation. Are you doing a home exercise program as well? My PT seemed to think, intially, that 6 weeks long enough for me to learn the exercises for strength and balance. However, since the start I have had a decline  but it looks as if i'm rebounding.

Looking forward to what the PTs on the forum think. Ashley? anyone?

Thanks for any input you can offer.
rendean