1. The Lived Experience of MS related impaired sensation in the feet.
I just want somebody to rub some life into them!
Claire Cook, Neurological Physiotherapist, School of Health Sciences, University of Brighton/Sussex Community NHS Foundation Trust
Dr. Pirjo Vuoskoski, Senior Lecturer, School of Health Sciences, University of Brighton
‘’… I think you just get used to it, I think it’s like if you break an arm you just adapt don’t you, it doesn’t make you unable to do things’’
Preliminary Findings
‘’…it’s like dead meat and this feeling of dead meat really.’’
‘’…I don’t look on it as a disability, I look on it as being less able’’
“…well I always feel better if I have spoken to a health professional…because they all understand as much as they can, without experiencing it.”
Context of the Study
Impaired sensation is a commonly reported symptom in people with Multiple Sclerosis (MS) (MS Society 2017).
Literature has demonstrated reduced sensation in the feet is linked to poor balance and an abnormal gait pattern in people with MS (Uszynski, Purtill & Coote 2015; Citaker et al, 2011; Thoumie and Mevellec 2002).
Quantitative studies have highlighted the importance of this phenomenon. However, this study aimed to explore the lived experiences of those who live with MS related impaired sensation in the feet based on a qualitative phenomenological approach.
“...when sensation goes in both feet, your feet sort of move but you don’t feel you’re moving so, I tend to then have to use a rollator or a wheelchair”
“They feel dead to me. I think it’s that skin on skin sensation that you miss…”
“…it feels as though I’ve got crisp packets folded up between my toes… I can even hear the sound of it happening… ‘’
Figure 2. Preliminary Structure: Interrelated key constituents of impaired sensation in the feet related to MS
“…at the time really it was denial. Nope, I haven’t got it…”
Methods
5 participants with MS were purposively recruited for individual, face- to-face, phenomenological interviews.
The interview transcripts were analysed using the steps of the Giorgi (2009) Descriptive Phenomenological Method seen in Figure 1.
Discussion
Conclusions
Descriptive phenomenological analysis of the raw data from five participants uncovered the essential, unifying structure, of the lived experience of MS related, impaired sensation in the feet.
Six key constituents were considered essential for the given phenomenon to present itself; their interrelatedness is presented in Figure 2.
When considered in light of previous evidence, common themes relating to experiences of diagnosis, experiences of falls and poor mobility, experiences of the interrelated symptom of fatigue and experiences of a disruption to the body, were highlighted.
Impaired sensation in the feet, related to MS, is a complex lived through phenomenon, closely interrelated to other symptoms of MS.
Healthcare Professionals may want to consider the significance of impaired sensation, related to MS, when assessing balance, mobility and falls risk.
The role of Healthcare Professionals is valued by people with MS; they are well placed to provide a source of advice and support.
References
Figure 1: Steps of the Giorgi Descriptive Phenomenological Method
Citaker, S., A.G. Gunduz, M.B. Guclu, B. Nazliel, C. Irkec, and D. Kaya Relationship between foot sensation and standing balance in patients with multiple sclerosis. Gait & Posture 34 (2):
Giorgi, A The Descriptive Phenomenological Approach in Psychology: A Modified Husserlian Approach. Pittsburgh: Duquesne University Press
MS Society The Invisible Symptoms of MS. Research Matters. Winter (012): 4-5
Thoumie, P., and E. Mevellec Relation between walking speed and muscle strength is affected by somatosensory loss in multiple sclerosis. Journal of neurology, neurosurgery, and psychiatry 73 (3):
Uszynski, M., H. Purtill, and S. Coote Relationship between foot vibration threshold and walking and balance functions in people with multiple sclerosis (pwms). Gait & posture 41 (1):