• Talking

• Writing

• Walking

• Climbing

• Balancing

• Stooping

• Kneeling

• Crouching

• Lifting

• Twisting

• Reaching

• Fingering

• Confusion,

• Motor coordination

• Eye-hand-foot coordination

• Stamina

• Strength

• Working in cold conditions

• Working in heat conditions

• Working in conditions where the temperature changes frequently

• Working in wet, humid conditions

• Vehicle operation

The extent to which multiple sclerosis creates a vocational impediment during the early stages of the disease depends primarily on the type of occupation in which the person is engaged. Persons engaged in professional, technical, managerial, clerical, and sales occupations may not encounter any specific vocational handicaps. On the other hand, for those engaged in agricultural and industrial occupations, even minor dysfunctions in coordination, dexterity, balance, gait, and muscle strength may have vocational implications. In all cases, there is no known cure or effective treatment for multiple sclerosis. It is likely to cause vocational impediments at some point in the progression of the disease.

Most persons are either employed or engaged in homemaking at the time of onset. The basic vocational rehabilitation strategy is one of maintaining current employment. This strategy is most readily achieved using rehabilitation engineering, job modification and restructuring, and assistive devices. Current employment in professional, technical, managerial, clerical, sales, and homemaking is a positive indicator for maintaining employment because cognitive functions remain intact, and physical demands can be altered with rehabilitation engineering approaches.

Brain function is best when the person is operating in a cool temperature. The temperature of the place where the person will be working is very important and needs to be a consideration when considering future employment for person with MS. A reasonable accommodation may be the installation of an air conditioning system. Retention of employment in agricultural and industrial occupations is more problematic because of the motor requirements involved and the temperature of the workplace. A thorough job and task analysis of current employment will usually disclose the extent to which a rehabilitation engineering approach can be applied. Close work with the employer will also indicate whether transfer into other jobs within the business is possible with or without some type of training.

Although it is tempting to consider rate of progress of the disease in determining the probability of retaining employment, this is pointless in everyday practice. There is no way to estimate this in the individual case, particularly when the person comes to vocational rehabilitation early in the course of the disease.