Tuesday, October 21, 2008

Multiple Sclerosis knee contractures

Patti’s MS related knee contractures have been high on my caregiving list recently. Multiple Sclerosis causes loss of movement in the legs triggering changes in the muscle, tendons and ligaments which in turn complicates bending or straightening.

After improvement following use of SoftPro Static Gel Knee Orthosis detailed in my August 11th entry, caregiving: memory loss and knee contracture ,
I’ve noticed a decline in her ability to extend her legs.

Recently chasing answers between shifts and staff, I learned the bottom line is that a certain patient has been most uncooperative. In a care facility staff cannot ‘force a patient against their will’, yada yada. So the knee orthosis have just been hanging out with the stuffed animals in Patti’s room.

Then I read a journal entry from another MS caregiver:

“I was turning Jeanne in bed, as I do every few hours throughout the day. … then I heard an unmistakable "crack." And although I had never heard this particular sound before, I instantly knew that her left leg had just been broken.”
MS Caregivers It Started With A Sickening Sound

Wow! Did this entry hammer home the risks?

Patti hates physical therapy. Trying to reason with her hits the brick wall of cognitive impairment. How to address the fight to keep Patti’s leg muscles, nerves, and joints functioning even though she is non-ambulatory?

Solution … Family and friends are not subject to institutional guidelines. We CAN argue with her to wear them and if need be amuse and distract her.

Patti’s parents visit a couple times a week and can get Patti to wear them when visiting. Jennifer had another excellent suggestion, why don’t I bring them home when Patti is visiting. While sitting around with her popcorn and ciggies would be an ideal time to wear them.

Let’s face it; wouldn’t some temporary squawking and cursing be better than the sickening sound of a crack?

Caregivingly Yours, Patrick Leer
website: http://www.caregivinglyyours.com/
videos: http://www.youtube.com/daddyleer
musings: http://patrickleer.blogspot.com/


  1. EEEK! Squawk away Patrick and maybe a bit of bribery.

  2. We have these range of motion machines now that patients wear after joint surgery. They keep the joint moving at all times. I wonder if that would be something she would wear at night? More important now a days. Would it be something insurance would cover?

  3. True that. I am starting (again) with a new PT, as always I go with high hopes that she knows what she is doing.

  4. those are wonderful solutions (having Patti's parents put them on for her while visiting, her wearing them at your house) It is hard to get them to do cooperate with what we know is good for them; they know it too, but it is uncomfortable I know; it is always a battle, was for getting my daughter to do physical therapy; I like that several different camps will be involved in implementing it too



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