10 Powerful Ways To Improve Your Balance When Living With Multiple Sclerosis

  1. EXERCISE 4-5 DAYS PER WEEK
  • Exercise by itself reduces common symptoms associated with MS including fatigue,1-5 spasticity,1 endurance1, quality of life,1,5 balance,1,2 and reduced depression.2
  • Exercise will help prevent decline and improve balance in 2 ways
    • Improved mood2 to promote living life.1,5
    • Decreases inflammation, to prevent progress of multiple sclerosis itself.
  1. OPTIMIZE YOUR WALKING DEVICE
  • Do you need one?
  • What do YOU need RIGHT NOW? (Cane, walker, rollator, etc.)
  • Correct height? Do you know how to use it? Everything working well?
  • Is it realistic and accessible? Do you need modifications for YOU? If you cannot easily use your walking device you will not be well balanced.
  1. HAVE YOUR SPECIFIC BALANCE SYSTEMS CHECKED [Inner Ear Balance System (Vestibular System) & Proprioception (Knowing Where Your Legs Are In-Space)].
  • It is common to have inner ear balance (vestibular) problems with or without dizziness with multiple sclerosis.6
  • Proprioception (Knowing where your legs are in-space) is a commonly missed problem in all populations, but so important for our balance.
  • Once this information is known, good decisions and treatments can be made.
  • The vestibular systems specifically is treatable with multiple sclerosis!7-9
  1. WALK, WALK, WALK
  • General exercise is great. If you want to be better balanced, you’ve got to walk.
  1. ADDRESS PROBLEMS RELATED TO MULTIPLE SCLEROSIS SPECIFIC TO YOU
  • Ankle-Foot Orthosis for drop foot?
  • Does spasticity need to be addressed with stretching or botox to help you move better?
  • Does one leg need to be strengthened to improve your balance?
  • Does depression need to be addressed with exercise, diet, or medication with guidance from your doctor?
  • Does cognition and/or memory need to be addressed? (Neurological Psychology, Speech Therapy, Physical Therapy).
  1. WALK FASTER
  • In general, we are all better balanced when we walk faster.10-12
  • This is due to specific mechanical reasons during the walking cycle.13,14
  • Walking faster will give you confidence, which will then help you balance better.12,13
  1. AVOID FURNITURE OR WALL WALKING
  • This trains your body to depend on your hands for balance instead of your legs. If your legs need assistance to be safe, you may need a cane or walker. Check with a Physical Therapist.
  • By depending on your legs, your balance will improve because your body will balance itself every day on its own without help.
  • Furniture walking will result in physical decline.
  • Physical decline13 and the perception of physical decline15  with multiple sclerosis will make your balance worse. Make your balance better by using your body normally to balance itself.
  1. CHECK YOUR BONE HEALTH
  • Low bone mineral density is associated with, and possibly a cause of the vestibular system (Inner ear balance system) not working correctly.16,17
  • Vitamin D deficiency is associated with getting vertigo18,19 and treating vitamin D deficiency reduces the risk of getting vertigo again.20
  1. IF YOU FALL, SEEK TREATMENT FROM A REHABILITATION PROFESSIONAL
  • Half of those with multiple sclerosis will fall over a 6 month period.21,22
  • A very small percentage of those with multiple sclerosis who have fallen will received any type of fall assessment from a rehabilitation professional, even after the fall.23
  1. EDUCATE YOURSELF ABOUT MULTIPLE SCLEROSIS
  • You may discover a treatment you didn’t know about that will help you move and balance better.
  • You may discover a new organization that can help.
  • You may find a different healthcare provider that can help you more for what you need.
  • You may eat better, live healthier, decrease inflammation, prevent progression of the disease.
  • Educating ourselves gives us a sense of empowerment, which will change the way you strut, which will help your balance.

 

                                                                                  References

 

  1. Tarakci E, Yeldan I, Huseyinsinoglu, BE, Zeenginler Y, Eraksoy M. Group exercise training for balance, functional status, spasticity, fatigue, and quality of life in multiple sclerosis: a randomized controlled trial. Clinical Rehabilitation. 2013;27:813-822
  2. Ahmadi A, Arastoo AA, Nikbakht M, Zahednejad S, Rajabpour M. Comparison of the Effect of 8 weeks Aerobic and Yoga Training on Ambulatory Function, Fatigue and Mood Status in MS Patients, Iranian Red Crescent Medical Journal. 2013;15:449-454
  3. Heine M, van de Port I, Rietberg MB, van Wegen EE, Kwakkel G. Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst Rev. 2015;11(9).
  4. Asano M, Finlayson ML. Meta-Analysis of Three Different Types of Fatigue Management Interventions for People with Multiple Sclerosis: Exercise, Education, and Medication, Multiple Sclerosis International. 2014.
  5. Dalgas U, Stenager E, Jakobsen J, Petersen T, Hansen HJ, Knudsen C., et al. Fatigue, mood and quality of life improve in ms patients after progressive resistance training, Multiple Sclerosis.2010;16:480-490.
  6. Zeigelboim BS, Arruda WO, Mangabeira-Albernaz PL, Iorio MC, Jurkiewica AL, Martins-Bassetto J, et al. Vestibular findings in relapsing, remitting multipole sclerosis: a study of thirty patients. Int Tinnitus 2008;14(2):139-145.
  7. Frohman EM, Zang H, Dewey RB, Hawker KS, Racke MK, Frohman TC. Vertigo in MS: Utility of positional and particle repositioning maneuvers. Neurology. 2000;55:1566-1568.
  8. Ozgen G, Karapolat H, Akkoc Y, Yuceyar N. Is customized vestibular rehabilitation effective in patients with multiple sclerosis? A randomized controlled trial. European Journal of Physical and Rehabilitation Medicine. 2016;52(4):466-478.
  9. Hebert JR, Corboy JR, Manago MM, Schenkman M. Effects of Vestibular Rehabilitation on Multiple Sclerosis-Related Fatigue and Upright Postural Control: A Randomized Controlled Trial. Phys Ther. 2011;91:1166-1183
  10. Callisaya ML, Blizzard L, Schmidt MD. A population-based study of sensorimotor factors affecting gait in older people. Age Ageing. 2009; 38:290-5.
  11. Rodacki ALF, Souza RM, Uginowitsch C, Cristopoliski F, Fowler NE. Transient effects of stretching exercises on gait parameters of elderly women. Manual Ther. 2009;14:167-72.
  12. Gianni C, Prosperini L, Jonsdottir J, Cattaneo D. A systematic review of factors associated with accidental falls in people with multiple sclerosis: a meta-analytic approach. Clin Rehabil. 2014;28(7):704-716.
  13. Kirkwood RN, Souza Moreira B, Vallone MLDC, et al. Step length appears to be a strong discriminate gait parameter for elderly females highly concerned about falls: a cross-sectional observational study. Physiotherapy. 2011; 97:126-31.
  14. Verghese J, Holtzer R, Lipton RB, Wang, C. Quantitative Gait Markers and Incident Fall Risk in Older Adults. J Gerontol A Biol Sci Med Sci. 2009 64A:896-901.
  15. Gunn HJ, Newell P, Haas B, Marsden JF, Freeman JA. Identification of Risk Factors for Falls in Multiple Sclerosis: A Systematic Review and Meta-Analysis. Phys Ther. 2013;93:1-31.
  16. Bigelow RT, Semenov YR, Trevino C, Ferrucci L, Resnick SM, Simonsick EM, Xue QL, Agrawal Y. Association Between Visuospatial Ability and Vestibular Function in the Baltimore Longitudinal Study of Aging. J Am Geriatr Soc. 2015;63(9):1837-1844.
  17. Singh NK, Jha RH, Gargeshwari A, Kumar P. Altered auditory and vestibular functioning in individuals with low bone mineral density: a systematic review. Eur Arch Otorhinolaryngol. 2018;275:1-10
  18. Han W, Fan Z, Zhou M, Guo X, Yan W, Lu X, Chen C, Wu Y. Low 25-hydroxyvitamin D levels in postmenopausal female patients with benign paroxysmal positional vertigo. Acta Oto-Laryngologica. 2018;138:5,443-446
  19. Jeong SH, Kim JS, Shin JW, Kim S, Lee H, Lee AY, Kim JM, Jo H, Song J, Ghim Y (2013) Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. J Neurol. 2013;260(3):832–838.
  20. Talaat HS, Kabel AMH, Khaliel LH, Abuhadied G, El-Rehem HA, El-Naga A. Reduction of recurrence rate of benign paroxysmal positional vertigo by treatment of severe vitamin D deficiency. Auris Nasus Larynx. 2016; 43: 237-241
  21. Gunn HJ, Newell P, Haas B, Marsden JF, Freeman JA. Identification of Risk Factors for Falls in Multiple Sclerosis: A Systematic Review and Meta-Analysis. Phys Ther. 2013;93:1-31.
  22. Finlayson ML, Peterson EW, Cho CC. Risk factors for falling among people aged 45 to 90 years with multiple sclerosis. Arch Phys Med Rehabil. 2006;87(9):1274-1279.
  23. Fritz NE, Eloyan A, Baynes M, Newsome SD, Calabresi PA, Zackowski KM. Distinguishing among multiple sclerosis fallers, near-fallers and non-fallers. Multiple Sclerosis and Related Disorders. 2018;19:99-104.
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Putting Healthcare Back In Your Hands

At Optimove Physical Therapy & Wellness it is important for the decision-making power about our clients’ plan of care and treatment to be between the client and the therapist. Optimove allows you to experience what medicine used to be, so you and the healthcare provider determine your plan together. Decisions about your plan are made by you in collaboration with your licensed therapist. Once the evaluation is completed, you and the physical therapist will decide together on how long the treatment should last, how often, and what the end-result will look like. We never give up on you and we are always there for you. We are relentless in the pursuit of you achieving the outcome you want.

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Do I need a Referral?

In the State of Texas, a physical therapy evaluation and the beginning of treatment can be performed without a referral. After that, we will send our evaluation to the healthcare provider of your choice and we will take it from there. All you need to do is provide the contact information for that healthcare provider, and we will do the rest. This other healthcare provider can be a physician, chiropractor, dentist, physician assistant, or nurse practitioner.

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Our Evaluations are designed to establish specifically what is wrong and why so we can work with our clients to design a customized plan for them. This includes gathering information, physical testing, and working together on a plan. Any background you can put together ahead of time such as medical information, timelines, imaging, medication lists, etc., is helpful. Although not required, filling out the intake forms can be done on-line, which can also help streamline the evaluation so you can get back to your day.

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This Free Discovery Visit is something that we offer to people so they can get more information face-to-face with us, in-person, so you know who your team is. Maybe you are unsure of the benefits we can provide for you, or if it is right for you. Maybe you would like to invite your children or spouse to help you decide if this is right for you. We understand you may have been let down in the past, so we want you to have as much information as you can without any cost or obligation before you commit to anything. If that sounds like you, then please start with a Free Discovery Visit that we can work with you to find out what is wrong and what can be done – without any financial risk on your part.

Matt Langford

Physical Therapist

Hi there! I'm Dr. Matt Langford. I have been working as a physical therapist in DFW for three years. My wife, our golden doodle named Birdie, and I love to spend our time going on different adventures whether it be hiking the Trinity trail or traveling to new places. I also love playing golf, pickleball, and serving at our local church in Fort Worth. My goals in life include learning more about the field of physical therapy so I can provide better care to individuals, pursuing my faith in a way that helps others know about Christ, and making as many memories as I can.

Kasondra Woodruff

Client Liaison

Kasondra is a mother and a pet lover, she loves spending time outdoors with her children and furry friends. With years of experience in client relations, her passion is ensuring that every client is heard and taken care of. As our Client Liaison, Kasondra takes pride in building strong relationships with our clients, ensuring that their needs are met and that they feel comfortable and confident throughout their time with us.

Jason Livas

Physical Therapy

Jason joined the Optimove team November 2023. He earned a Bachelor of Science in Exercise Science from the University of Texas at Arlington in 2012 followed by an Associate of Applied Science in Physical Therapy from Navarro College in 2019.
Jason’s clinical interests include neuromuscular training for healthy aging and longevity of the older adult, orthopedic rehabilitation and strength and conditioning. Jason also maintains certifications as a Certified Strength and Conditioning Specialist (CSCS) and trigger point dry needling (Cert DN).
Outside of work, Jason enjoys cooking, reading, strength training and spending time with his beautiful wife and kids.

Connie Thomason

Occupational Therapist

Connie holds a Master of Occupational Therapy from Texas Woman’s University (1997) and boasts over 26 years of experience as an Occupational Therapist. Her expertise lies primarily in neurological rehabilitation within a hospital-based outpatient setting. Throughout her career, Connie has worked across various healthcare settings including Acute, SubAcute, Skilled Nursing, and In-Patient Rehab.
Her specialization in Vestibular Rehabilitation since 2005 has equipped her to effectively treat a wide array of conditions, including BPPV, Vestibular Migraine, Meniere’s Disease, acute and chronic hypofunction, Acoustic Neuroma, PPPD, balance disorders, central vestibular disorders, concussion, and Superior Canal Dehiscence.
Connie holds numerous certifications, including the 360 Neuro Health Certificate of Competency in Vestibular Rehab, Emory University Vestibular Rehabilitation Competency-Based Course, 360 Neuro Health V2FIT for concussion, Lee Silverman Voice Therapy (LSVT) BIG for Parkinson’s patients, Neuro Developmental Treatment (NDT) for stroke patients, and NASM Corrective Exercise certification. She is also certified in the Montreal Cognitive Assessment (MoCA).
Active in professional communities, Connie is a member of the American Occupational Therapy Association and the Vestibular Disorders Association.
Outside of her professional endeavors, Connie enjoys spending time with her husband of 30 years, along with their two rescued bulldogs. Her hobbies include riding motorcycles, traveling, running, painting, and reading extensively about health, wellness, and vestibular research.

Andy Altmoyer

Operations Manager

Andy grew up as part of a military family, living all over the country and abroad. He is so glad to have finally landed back in Texas. He earned a bachelor’s degree in Secondary Social Studies Education, minoring in Vocal Music and Theater from West Liberty University in West Virginia. Since then he has used his outgoing nature, education background, and organizational skills in healthcare management and operations. When he isn’t working he enjoys spending time with his family and dogs, reading Marvel comics, and cooking.
During Andy’s first venture into healthcare, while living in Ohio, he worked for a practice focused on Orthopedics where he spent time managing their Physical Therapy front desk across multiple locations as well as being a group fitness instructor for seniors, folks with special needs, and those who have had total join replacements. It’s here that he realized his deep love of helping people navigate the healthcare system and connecting them with those can meet their mobility needs.
Sad to leave that company after over 7 years, Andy and his family moved to Dallas where Andy spent 3 years as Operations Manager for a large Neurology practice. He continued helping people connect with top tier healthcare providers, navigating the pandemic, and moving the practice’s location in stride. It was during this time that Andy met Dr. Guild. The Optimove Team became a favored referral source for some of the physicians on staff and Andy got to work with their team closely as they coordinated care for the patients.
This collaboration led to Andy joining the Optimove Team in August of 2021. Andy has a unique blend of experiences not only professionally but personally as well. He has been able to assist so many people reach the correct providers to have their needs met and provides valuable insight to the workings of the healthcare system at large and how to make it work better for our clients. This also comes from helping his mother navigate worker’s compensation and disability as well as assisting his family setting up his grandparents with memory care, assisted living, physical therapy, and other services. Andy has often been quoted as saying, “I may not be the one laying the healing hands but connecting folks to the right people who can help them makes me feel like I’m a part of something great and makes me feel good.”
Andy would like to be a part of your journey towards independence and wellness. He loves getting to know our clients and being one of their biggest cheerleaders throughout their journeys. Give him a call and take the first steps to achieving your goals.

Peter Langlois

Physical Therapy

Peter keeps our clients laughing, and the whole Optimove Team as well. Hand-picked by Jeffrey from their previous rehabilitation work, when he is not being “The Joint Whisperer” and making the seemingly impossible happen, Peter is MacGyvering up some gadget for our clients to help them move better.
Peter is originally from Rhode Island. He received his bachelor’s degree from the University of Rhode Island where his first career was as a ship captain, where he travelled the world and experienced many different cultures. Peter later developed a passion for physical therapy from his running career as a long distance runner doing marathons and ultramarathons. This led him to switch careers as he wanted to learn more about injury prevention and rehab. Peter has worked in various facilities over the last 8 years as a therapist throughout the metroplex including skilled nursing, outpatient orthopedics, and home health. He now enjoys working with our clients on various movement disorders, gait mechanics and balance issues. In his spare time Peter enjoys chopping wood and going for long trail runs with his family.

Jeffrey R. Guild, PT, DPT, (Former CSCS)

Owner, Therapist

When Dr. Jeffrey Guild is not working as business owner and clinician, he is dedicating time to his wife and children. His other hobbies include working out (Mainly in the weight room), music (Listening, playing, & researching), history, science, and studying business and successful people.
Jeffrey is originally from Bettendorf, Iowa and went to The University of Iowa and graduated with a bachelor’s degree in Health Promotion (Minors in Integrative Physiology & Psychology). He also worked as a Strength & Conditioning intern with The University of Iowa for 3 years and volunteered in cardiac rehabilitation at The University of Iowa Hospitals & Clinics. Upon arriving to Texas, he interned at the Cooper Aerobics Center.
Jeffrey’s first career was as a strength & conditioning professional and personal trainer. Even in the fitness industry he specialized in working with people who were older and with physical limitations. His particular emphasis as a personal trainer was identifying basic movement problems to prevent injuries BEFORE the training started, which gave him a greater understanding about human movement and was a natural segway towards Physical Therapy.
Jeffrey graduated with a Doctorate Degree in Physical Therapy at The University of North Texas Health Science Center in Fort Worth in 2013. He received the Dean’s research Award for the Allied Health Department and got published in multiple journals. After physical therapy school he started his career by receiving mentoring for over a year working in a vestibular/neurological specialty outpatient practice. Since then he has worked in a number of areas of physical therapy including inpatient rehabilitation, acute care, skilled nursing, memory care, and even pediatrics. In 2018 he started his own practice with the name “Optimove” with the emphasis on a combination of “optimal movement” and “optimism.”