“Looking at the evolution of assistive devices and technologies available for people with MS, one has to realize that ‘state of the art’ is always a moving target. At one point, the folding wheelchair was the latest advancement and people could finally take their chair in the car. Since that time, not only have better wheelchairs come along, but we’ve also seen a broadening of the types of products people with MS need and want – their expectations have grown beyond traditional medical equipment.

“Psychological understanding of MS has evolved greatly since the beginning of the 20th century. For many years, cognitive impairment was rarely distinguished from mental symptoms. The relationship between mood, cognition, and disease course were not known. Early efforts relied on psychoanalytic case histories correlated to findings on the Rorschach (inkblot) tests to try to characterize the type of individual who was prone to MS.

“Disability in MS is multifactorial. Lesions can occur in any area of the central nervous system (CNS), and therefore a variety of impairments are possible. Balance loss is common in MS because it occurs not only from myelin loss, but also from a variety of symptoms such as weakness, stiffness, sensory loss, pain, and loss of muscle control. Fatigue is a common MS symptom and can be a major reason for falls and balance loss. Research has shown that people with MS are far more likely to fall when fatigued.

“My first MS patient in 1971 had been in a wheelchair for twelve years (recommended right after diagnosis) when she was referred for treatment of a fractured shoulder from a fall. She was highly motivated, the shoulder recovered well, and she requested further treatment for her MS. There was nothing in the literature at that time, but her doctor and I were willing to give it a try in once-weekly sessions.

“Treatment for individuals with MS has evolved considerably over the years. In occupational therapy, one major advance has been the broad use of computer technology to benefit individuals with MS.

“Many of the preceding commentaries rightfully focus on the dramatic and life-changing advances that have been made in MS diagnosis, treatment, symptom management, and quality of life. Together, these have resulted in improvements in overall outcomes for many patients.

MS Timeline 1380: St. Lidwina born in Holland; her progressive illness suggests a diagnosis of MS 1794: Birth of Augustus d’Este, an early case of what would later be known […]

The evolution of multiple sclerosis (MS) diagnosis, treatment, and care, from the early 1800s to today, has been an extremely long and difficult road for researchers, medical professionals, and members of the MS community alike. Through the 1800s and up until the mid 1900s, without the diagnostic tools of today, some individuals showing signs of MS may not have received a diagnosis during their lifetime.