Question: How can I prevent deterioration in upper limbs, balance, and mental abilities?

Answer:
To prevent deterioration in upper limbs, it is recommended to:

1. Use your hands as much as possible in daily activities. For example, take breaks during kitchen work or other household chores if you feel fatigued. Consider performing tasks seated if standing is challenging (e.g., dressing, folding laundry, or chopping vegetables).
2. Engage in enjoyable activities that involve hand use, such as ball games or gardening.
3. Practice exercises to maintain abilities, such as shoulder and scapula movements, exercises with a stick (while sitting or lying), fine motor exercises with clothespins, or games like puzzles, cards, or board games.
4. If functional difficulties arise, consult an occupational therapist for targeted intervention.

To prevent deterioration in balance, it is recommended to:

1. Practice standing up and walking under supervision.
2. If there are episodes of balance loss or falls, consult a physiotherapist about walking aids.
3. Request a referral for physiotherapy or hydrotherapy (covered annually by health insurance providers).

To prevent deterioration in mental/cognitive abilities, it is recommended to:

1. Lead an active lifestyle, including physical activity, household tasks, social interactions, or joining a club or other social framework.
2. Train cognitive skills through activities such as Sudoku, crosswords, or cognitive games. Many cognitive game apps are available (e.g., SET, Rush Hour, or spot-the-difference games). Additionally, cognitive training software such as Cognishine (via Clalit Health Services) and Effectivate is available.
3. Use the MS Society’s online platform for cognitive exercises and digital thinking games for people with MS.
4. Request a referral to an occupational therapist for cognitive assessment and personalized treatment.

Question: I have difficulties with fine motor skills—objects fall from my hands, and I struggle with delicate tasks like tying shoelaces. Are there exercises or treatments?

Answer:
To maintain fine motor skills, it is recommended to:

1. Practice fine motor activities using household items, such as collecting coins and placing them in a container, crumpling and tearing paper, or using modeling clay or TerraPlast for exercises.
2. Engage in creative activities like drawing, coloring, beadwork, or working with clay.
3. Play games that promote fine motor skills, such as board games, card games, chess, or backgammon.
4. If difficulties significantly impact functionality, consult an occupational therapist for tailored treatment.

Question: Activities involving the hands (e.g., using a ball, elastic bands, weights, blocks, or a pencil) lead to total exhaustion, and I avoid repeating such activities. What should I do?

Answer:
Physical exercise is essential to maintaining abilities. However, the exercises must be adapted to each person’s capacity.

1. Adjust exercise intensity: If you fatigue quickly, select a single exercise or limit the duration of each session.
2. Choose appropriate timing: Avoid exercising on days when you’ve already exerted yourself with other tasks.
3. Modify the type of exercise: Avoid using weights or resistance bands if fatigue is severe. Instead, perform exercises that involve moving your arms against gravity (e.g., raising your arms). This can still provide strengthening benefits.

For support in managing symptoms and fatigue, consult an occupational therapist to develop strategies for improving functionality while minimizing exhaustion.