Herb Karpatkin, PT, DSc, NCS, MSCS :- Multiple Sclerosis Community -: Support Group

Herb Karpatkin, PT, DSc, NCS, MSCS

Joined: 06/11/2012

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Herb Karpatkin, PT, DSc, NCS, MSCS received his Masters degree in Physical therapy from Boston University in 1989 and a Doctor of Science degree from Rocky Mountain University in 2009. He is a board certified Neurologic Clinical Specialist from the American Physical Therapy Association since 1997, and is a board certified Multiple Sclerosis Specialist from the Consortium of Multiple Sclerosis Centers since 2005.

His work has been published in the Archives of Physical Medicine and Rehabilitation, the, Journal of Neurologic Physical Therapy, and the International Journal of Multiple Sclerosis. He conducts clinical research examining the effects of different exercise paradigms on fatigue in multiple sclerosis. He has held clinical and supervisory posts at New York University Medical Center, Beth Abraham Hospital, The Hospital for Joint Diseases, Burke Rehabilitation Hospital, and the International Multiple Sclerosis Management Practice. He has held academic positions at Touro College, Dominican College, , and is currently an assistant professor in the Doctor of Physical therapy program at Hunter College. He has presented nationally to both peers and patient groups on topics in Multiple Sclerosis, exercise, and physical therapy.

He also maintains a small private practice specializing in the treatment of patients with Multiple Sclerosis.

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Reply: Do anyone have any suggestions?

I would also suggest you contacting an occupational or physical...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

19 Replies | Reply | Watch This DiscussionReport This| Share this:Do anyone have any suggestions? I would also suggest you contacting an occupational or physical...

Reply: Functional Electical Stimulation

Hello dave- sorry for the delay in responding to your...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

8 Replies | Reply | Watch This DiscussionReport This| Share this:Functional Electical Stimulation Hello dave- sorry for the delay in responding to your...

Reply: Functional Electical Stimulation

Sorry for the delay in getting back to you. First, i would talk...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

8 Replies | Reply | Watch This DiscussionReport This| Share this:Functional Electical Stimulation Sorry for the delay in getting back to you. First, i would talk...

Reply: Functional Electical Stimulation

I have several comments and questions about your exercise...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

I have several comments and questions about your exercise regime.
1-First, it seems like all of the exercises you list are open chain. Do you do any closed chain exercises? This is important as most of the hip abductors function is as a lateral stabilizer of the pelvis during gait and balance while in a closed chain position. I can suggest several closed chain hip abduction exercises if youd like.
2- In my practice I have found that 2 things are essential in increasing strength in MS
first, increasing the emphasis on eccentric contractions. Eccentric contractions are less fatiguing, but can build strength just as well if not better than concentric contractions. Therefore for all of your exercises, I recommend making the concentric phase at a normal speed and the eccentric phase at a very slow speed
Second, I strongly suggest you perform your exercise in an intermittent manner. What this means is that rather than performing a specific number of sets and reps, you exercise until you reach a moderate amount of fatigue, then recover for 10-30 seconds, then repeat. The reason for this is that MS neurogenic fatigue makes doing a high volume of quality repetitions difficult if done continuously. However, if rests are taken, a much greater number of repetitions can be achieved, resulting in a higher volume of work performed, and therefore greater functional improvment. In research i am currently conducting, we are having patients perform SLR's continuously (eg without breaks) and intermittently (taking breaks every 10 seconds after 2 repetitions. The results have been clear that in the intermittent condition MS patients have usually more than doubled the number of SLR's that they can perform.
What are the functional repercussions of your hip weakness? Is your gait and balance affected? Is there a trendelenberg?
Do you have spasticity or contractures? These can worsen the affects of hip abductor weakness.
What medication do you take, specifically do you take baclofen or ampyra?
Sorry to anser you with more questions, but the better picture i have of your situation the more i may be able to assist youView Thread

Posted byHerb Karpatkin, PT, DSc, NCS, MSCS

8 Replies | Reply | Watch This DiscussionReport This| Share this:Functional Electical Stimulation I have several comments and questions about your exercise...

Reply: Functional Electical Stimulation

The use of Functional Electrical Stimulation (FES) has been...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

8 Replies | Reply | Watch This DiscussionReport This| Share this:Functional Electical Stimulation The use of Functional Electrical Stimulation (FES) has been...

Reply: fatigue and exercise

The first question I would ask you is about your pain, as in my...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

4 Replies | Reply | Watch This DiscussionReport This| Share this:fatigue and exercise The first question I would ask you is about your pain, as in my...

Reply: pain and stiffness of the spine

Your pain sounds less like MS and more like low back pain due...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

2 Replies | Reply | Watch This DiscussionReport This| Share this:pain and stiffness of the spine Your pain sounds less like MS and more like low back pain due...

Reply: help

Glad to have been of some help. If the increased frequency of...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

9 Replies | Reply | Watch This DiscussionReport This| Share this:help Glad to have been of some help. If the increased frequency of...

Reply: Question about fatigue

Your symptoms certainly sound as if they are related to MS. I...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

120 Replies | Reply | Watch This DiscussionReport This| Share this:Question about fatigue Your symptoms certainly sound as if they are related to MS. I...

Reply: Painful Legs during sleep and blood tests question...

The 2 most likely culprits are spasticity and neuropathic pain...

Posted by Herb Karpatkin, PT, DSc, NCS, MSCS

2 Replies | Reply | Watch This DiscussionReport This| Share this:Painful Legs during sleep and blood tests questions The 2 most likely culprits are spasticity and neuropathic pain...