Longer term effectiveness of inpatient multidisciplinary rehabilitation on health-related quality of life in MS patients: a pragmatic randomized controlled trial - The Danish MS Hospitals Rehabilitation Study (original) (raw)
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Multiple Sclerosis Journal, 2019
Background: Inpatient multidisciplinary rehabilitation (MDR) can improve health-related quality of life (HRQoL) in multiple sclerosis (MS) patients. However, the evidence of a long-term benefit is limited. Objectives: To investigate the long-term effectiveness of inpatient MDR on HRQoL in MS patients. Methods: We conducted a randomized controlled partial crossover trial with 427 MS patients. Results: Statistical significant long-term improvements in HRQoL were found in three of the six outcome measures at 12-month follow-up. Three in four suggested minimal clinically important differences (MCIDs) were unmet. Conclusion: These results indicate that the administration of inpatient MDR may lead to long-lasting improvements in HRQoL in MS patients.
Journal of Neurology, Neurosurgery & Psychiatry, 2008
Objective: A stratified, randomised, waitlist controlled study over 12 months assessed the effectiveness of rehabilitation in persons with multiple sclerosis (MS) in an Australian community cohort. Methods: Patients with definite MS (n = 101) recruited from a tertiary hospital database, randomised to a treatment group (n = 49) for individualised rehabilitation programme or a control waitlist group (n = 52). Functional Independence Measure (FIM) was used to assess ''activity'' while the Multiple Sclerosis Impact Scale (MSIS-29) and General Health Questionnaire (GHQ-28) assessed ''participation'' and quality of life (QoL). Assessments were at baseline and 12 months. Results: Analysis of data from 98 patients (treatment n = 48, control n = 50) showed reduced disability in the treatment group, with statistically significant differences in post-treatment FIM motor scores for the two groups (p,0.001). There was a clinical and statistically significant improvement in FIM (motor) total scores (p,0.001), and the FIM motor domains of: transfer (p,0.001), locomotion (p,0.001), self-care (p,0.001) and the FIM cognitive subscale (p,0.016). In the treated group, 70.8% improved compared with 13% of controls. Significantly more patients in the control group deteriorated over the study period (58.7% vs 16.7%; p,0.001). There were no differences between the control and treatment group scores on the MSIS-physical (p = 0.18), MSIS-psychological (p = 0.45) or GHQ subscales. Conclusion: An individualised rehabilitation programme reduces disability in persons with MS compared with no intervention. The impact of rehabilitation on QoL needs further evaluation. More information on the effectiveness of the various components of the multidisciplinary rehabilitation programmes are now needed. Australian clinical trials registry: Trials registration number: ACTRNO12605000676617.
Study about the effects of rehabilitation on quality of life in multiple sclerosis patients
Advances in Nursing & Midwifery, 2011
Background and aim Multiple sclerosis is a progressive demyelization disease which can progress to physical disability in many patients. People with multiple sclerosis face many problems and complications which require appropriate education and interventions. Multidisciplinary neurorehabilitation is an effective treatment for quality of life improvement in MS patents. The purpose of this study is to examine the effect of Hayate noo center rehabilitation protocol on quality of life of MS patents. Materials and methods In this clinical trial 130 MS patients (65 patients as treatment group and 65 as control group) were studied. Participants were randomly selected from patients attending Iran MS society in Tehran. The two groups were matched in terms of sex, age, education, type of MS , marital status , time of onset of MS, and disability status. A questionnaire was used for data collection . The questionnaire consisted of three parts .Part one is demographics information and the 2end p...
Physical rehabilitation has a positive effect on disability in multiple sclerosis patients
Neurology, 1999
Artide abstraet-Background: Although physical rehabilitation is commonly administered to MS patients, its efficacy has not been established. Objective: We assessed the efficacy of an inpatient physical rehabilitation program on impairment, disability, and quality of life of MS patients with a randomized, single-blind, controlled trial. Methods: Fifty ambulatory MS patients were assigned to 3 weeks of inpatient physical rehabilitation (study treatment) or exercises performed at home (control treatment). Patients were evaluated at baseline and at 3, 9, and 15 weeks by a blinded examining phyaician. Results: No changes in impairment occurred in either group, as measured by the Expanded Disability Statue Scale. At the end of the intervention the study group improved significantly in disability, as assessed by the Functional Independence Measure (FIM) motor domain, compared with controls (p = 0.004), and the improvement persisted at 9 weeks (p = 0.001). The effect size statistic was usually large or moderate in all scale scores of the FIM motor domain at 3 weeks and moderate to fair thereafter. The study group also improved in overall health-related quality of life profila compared with controls; however, the differente was significant only for the mental composite score at 3 (p = 0.008) and 9 weeks (p = 0.001). Conclusions: Despite unchanging impairment, physical rehabilitation resulted in an improvement in disability and had a positive impact on mental components of health-related quality of life perception at 3 and 9 weeks.
The impact of inpatient rehabilitation on progressive multiple sclerosis
Annals of Neurology, 1997
One of the primary aims of rehabilitation for patients with multiple sclerosis (MS) is to reduce their levels of disability and handicap, yet little systematic research into the outcomes of this intervention has been undertaken. This stratified, randomized, wait-list controlled study evaluated the effectiveness of a short period of multidisciplinary inpatient rehabilitation in people with MS. Sixty-six patients in the progressive phase of the disease were assessed at 0 and 6 weeks with validated measures of impairment (Expanded Disability Status Scale and Functional Systems), disability (Functional Independence Measure), and handicap (London Handicap Scale). Both groups were comparable in terms of age, sex, disease duration and severity, disability, and handicap. At the end of 6 weeks, although the level of impairment in both groups remained the same, those who participated in a short period of inpatient rehabilitation (average of 25 days) significantly improved their level of disability and handicap compared with those in the wait-list control group. Despite unchanging impairment, inpatient rehabilitation resulted in reduced disability and handicap in patients with progressive MS.
Multiple Sclerosis Journal - Experimental, Translational and Clinical
Background Persons with multiple sclerosis may benefit from hospital-based multidisciplinary rehabilitation. Objectives To investigate the effects of hospital-based multidisciplinary rehabilitation and to identify their potential predictors in a large sample of persons with multiple sclerosis. Methods From the charts of 655 persons with multiple sclerosis consecutively admitted to our unit, disease profiles, modified Barthel index, Expanded Disability Status Scale (EDSS), pain numerical rating score and type of interventions were retrospectively collected. We defined an improvement at discharge as follows: modified Barthel index increase of at least 5 points, EDSS decrease of 1.0 if baseline score was 5.5 or less and of 0.5 if baseline score was greater than 5.5; any numerical rating score decrease. Results After a median admission period of 36 days, at discharge 65%, 22% and 89% of persons with multiple sclerosis improved for modified Barthel index, EDSS and numerical rating score,...