Weighted vest, therapy keep MS patient steady on his feet

Brownsburg man, diagnosed with multiple sclerosis a decade ago, is keeping the progression of the disease at bay with special tools and exercises.

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

It might look like Chris Kijovsky is playing a game using virtual reality technology, but it’s no game.

Kijovsky is focused on staying upright while standing on a platform as a dizzying pattern of black and white boxes moves around him.

He is strapped into a harness and focused on the center of the three-dimensional image, shifting his hips, shoulders and heels to try to keep his body aligned.

Next, he is instructed to close his eyes and try to stand still. The wall and the platform move in response to his body.

It might not seem so difficult until you hear that the 44-year-old Brownsburg man has multiple sclerosis, a disease of the central nervous system that disrupts communication between the brain and the rest of the body.

In Kijovsky’s case, the disease has slowly robbed the former runner of his ability to walk long distances or maintain his balance.

Diagnosed 10 years ago, he has managed his symptoms fairly well, but last July he came to the IU Health Neuroscience Center on the advice of his neurologist, Dr. Jaison Grimes, for physical therapy and to be fitted with a balance vest.

The vest has been a game-changer, says physical therapist Priya Gangwani.

“When you first came in here, you couldn’t walk without the cane at all,” she said to Kijovsky. “You were very dizzy and holding onto things for balance.”

He remembers all too well.

A trip to the St. Louis Zoo with his wife and two kids over fall break showed him how far he has come.

“I thought for sure I was going to have to rent one of those motorized scooters, and I never did,” he said, adding that he wore his weighted balance vest under a sweatshirt for much of the day.

“My balance is much improved, but I have the cane just in case. I don’t know when I might need it, but it’s usually when I get tired.”

On this fall morning at the Neuroscience rehab clinic, he is feeling pretty confident as Gangwani checks the weights in his vest that are positioned primarily on the right side to help his balance.

“I could easily walk back to my car right now without the cane.”

But first, Gangwani wants to put him through his paces, literally, in a nearby hallway.

She is by his side as she instructs him to walk at a normal pace, turn, look to the right and to the left, then resume walking. When he stops again, she tells him to look down, then up, then down again. All of those movements can result in dizziness and a loss of balance for Kijovsky, but he completes the exercise with only a couple of missteps.

Next, he must walk the same hallway while stepping up and over small obstructions, then climb up and down a nearby stairway. Gangwani is by his side every step of the way.

“It’s probably not too impressive what I just did, but I couldn’t have done that without falling down before,” he said.

But Gangwani is impressed. She said her patient has come a long way since July, noting how he scored a 14 out of 30 on the previous exercise in the early days. Today, he scored 25 out of 30.

That’s a credit to his therapy, his vest and his commitment, she said.

“It’s amazing to see functionally how much more he can do. He takes a lot of responsibility and does his exercises at home, which is half the battle,” she said. “We can only tell you what to do, but you have to be committed in doing the exercises.”

Kijovsky is nothing if not committed. He is fortunate to be able to work from home, he said, and fits his exercises into his schedule.

“He is the poster child of what therapy should be and how it should be followed, and we are seeing the results because of that,” Gangwani said.

Physical therapist Kathryn Gyves, who has worked closely with Kijovsky to get his vest properly fitted and balanced, steps in to test his balance, alternately pushing him gently to the right and to the left to check his stability.

“I’m not trying to be mean,” she laughs.

The balance-based torso weighted vest he wears is ideal for anyone who has balance or postural instability, she said, including patients with MS, Parkinson’s, cerebellar ataxia and neuropathy.

“This has been fitted for him and weighted specifically for him,” she said, “not based on his size but on his impairments.”

Reaching overhead used to be a challenge, Kijovsky said, recalling how he once reached up onto the refrigerator at home to get a glass coffee pot, got dizzy and saw the pot shatter at his feet.

“Now I can reach up to get a box of cereal with no problem,” he said, “but I won’t be putting a glass coffee pot on top of the fridge anymore.”

Before he began his most recent therapy, he struggled to do household chores like mowing the lawn.

“I feel so good now that I do more than I should. I just stained my fence,” he said. “But then I was exhausted.”

Gyves is pleased to see him doing so well.

“This is all him,” she said, calling him a model patient. “It’s motivating when you start to see improvement. That’s just human nature.”

Kijovsky has been discharged from weekly therapy, but he will return to the clinic in several months so the team can reassess how well he is doing with the vest and determine if the half- and quarter-pound weights tucked inside should be repositioned or taken out.

Photos and video by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org