Pat Provance, PT, MSCS
Semi-retired physical therapist
…on exercise and ambulation aids in MS rehabilitation
“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. Beginning with simple isometrics and functionally-focused activities, she gradually progressed to standing, parallel bars, a walker, and finally forearm crutches after about six months.
“That was my epiphany as a physical therapist – that this population was misunderstood and de-conditioned as a result of the fear of fatigue! The medical community now recognizes the importance of customized exercise programs for this population, to improve functional strength, balance, endurance, and quality of life.
“Ambulation assistance has been enhanced as well. Foot drop braces formerly made of heavy polypropylene have been replaced by lightweight carbon products or wireless FES (functional electrical stimulation). Other ambulation aids that were previously bulky, unwieldy, or heavy, have now evolved to lightweight, user-friendly assists. Independence, dignity, and safety, while improving function, are now all possible as we continue to improve with technology and knowledge.”
Pat Provance was in full-time clinical practice from 1971 to 2006, and many of those years were devoted to MS care. In 1982, she started the first MS Rehabilitation Program at Union Memorial Hospital in Baltimore. In 2000, she joined the University of Maryland team and directed the outpatient MS Rehabilitation Program at Kernan Rehabilitation Hospital, which included teaching, research, and consulting with the MS center. Ms. Provance has published numerous articles in journals for MS patients and co-authored Kendall’s Muscles, Testing and Function with Posture and Pain. Now “semi-retired,” she continues to teach and consult on MS rehabilitation across the country.