Rehabilitation of Patients with Multiple Sclerosis

Overview

Background.
During the last decades a significant progress in rehabilitation of patients with multiple sclerosis (MS) has been achieved. This pilot study aims to study effect of weeks-lasting rehabilitation programme of MS patients in conditions of non-profiled inpatient rehabilitation unit.Methods and Results. The rehabilitation program of 25 hospitalised patients was mostly aimed at complex kinesitherapy and physical therapy, partly also at ergotherapy and orthetics. Functional status of patients was evaluated at the beginning of the hospital stay and before dismission. Spasticity of lower limbs was scored using Global Assessment of Spasticity Scale (GSA) and modified Ashwort’s scale. Motor subscore of Functional Independence Measure (FIM) was used to assess the patient’s disability. In interval of 5 to 6 months a questionnaire was distributed among the patients to evaluate the rehabilitation stay. During the rehabilitation none of the studied patients got worse. At the beginning of hospitalisation average EDSS was 6.7 (median 6.5) ± 1.0, before the demission it was 6.5 (6.5) ± 0.9. Among the parameters studied statistically significant improvement came in the modified Ashwort’s scale (from 2.5±0.8 to 1.8±0.6) and in the motor subscore of Functional Independence Measure (from 59±15 to 64±14). No statistically significant difference was found when the Global Assessment of Spasticity Scale was used - the improvement score of the group was 1.0±0.7. Not all of questionnaires returned. The results obtained from responders showed positive evaluation of the rehabilitation program, which lasted for several months.Conclusion. Results of the study correspond to the literary data both in immediate effects of the treatment and in its persistence after dismission. As important reveals the fact that most of the patients has primary or secondary progressive MS. It can be reasonably presumed that further improvement of the rehabilitation of patients with neurological diseases could be achieved in specialised neurorehabilitation centres.

Key words:
multiple sclerosis, physiotherapy, neurorehabilitation, rehabilitation, spasticity