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Prognostic factors in multidisciplinary rehabilitation treatment in multiple sclerosis: an outcome study

Fondazione Santa Lucia-IRCCS, Via Ardeatina 306, 00179-Rome, Italy, mg.grasso{at}hsantalucia.it

E Troisi

Fondazione Santa Lucia-IRCCS, Via Ardeatina 306, 00179-Rome, Italy

F Rizzi

Fondazione Santa Lucia-IRCCS, Via Ardeatina 306, 00179-Rome, Italy

D Morelli

Fondazione Santa Lucia-IRCCS, Via Ardeatina 306, 00179-Rome, Italy

S Paolucci

Fondazione Santa Lucia-IRCCS, Via Ardeatina 306, 00179-Rome, Italy

The aim of this outcome study was to evaluate the effectiveness and prognostic factors of inpatient multidisciplinary rehabilitation treatment in patients with multiple sclerosis (MS). We analysed 230 consecutive inpatients with MS admitted to an MS rehabilitation ward who followed an individualized, goal-oriented, multidisciplinary rehabilitation program. Every patient was submitted to a neurological examination and evaluated by means of Kurtzke’s Expanded Disability Status Scale (EDSS), with its functional systems (FS), Barthel Index (BI) and the Rivermead Mobility Index (RMI). We observed an effectiveness (percentage of potential improvement achieved during rehabilitation) of nearly 16% on BI and 8% on RMI, corresponding to an improvement in 124 patients (54%) on BI and 113 patients (49%) on RMI. Basal EDSS (ß= -0.32, p<0.001), cognitive status (ß= -0.15, p<0.05) and disease duration (ß= -0.13, p<0.05) were negatively associated with effectiveness of treatment on BI (adjusted R²=0.176), whereas effectiveness on RMI was correlated only with the EDSS score (ß=-0.34, p<0.001, adjusted R²=0.113). In the logistic regression analysis, the absence of severe sphincteric disturbances was correlated with the probability of improvement on BI that was nearly twice as high (OR=2.25, 95% CI 1.24-4.08) as that of other patients. Moreover, patients without severe cognitive deficits showed a similar probability (OR-2.37, 95% CI 1.05-5.33) of improvement on RMI. The results of this study provide further evidence that intensive multidisciplinary rehabilitation in MS is effective in the majority of MS patients and that early treatment may favour functional recovery.

Key Words: multiple sclerosis • prognostic factors • rehabilitation

Multiple Sclerosis, Vol. 11, No. 6, 719-724 (2005)
DOI: 10.1191/1352458505ms1226oa


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				F Khan, J F Pallant, C Brand, and T J Kilpatrick Effectiveness of rehabilitation intervention in persons with multiple sclerosis: a randomised controlled trial J. Neurol. Neurosurg. Psychiatry, November 1, 2008; 79(11): 1230 - 1235. [Abstract] [Full Text] [PDF]