Rehabilitation
Rosti-Otajärvi EM, Hämäläinen PI. Neuropsychological rehabilitation for multiple sclerosis. Cochrane Database Syst Rev. 2011 Nov 9;11:CD009131.
The aim of this review was to evaluate the effects of neuropsychological/cognitive rehabilitation in MS by conducting a systematic review. The review indicates low level evidence for the positive effects of neuropsychological rehabilitation in MS. Interventions included in the review were heterogeneous. Consequently, clinical inferences can basically be drawn from single studies. Therefore, new trials may change the strength and direction of the evidence. To further strengthen the evidence, well-designed high quality studies are needed. In this systematic review, recommendations are given for improving the quality of future studies on the effects of neuropsychological rehabilitation in MS.
Khan F, Amatya B, Turner-Stokes L. Symptomatic therapy and rehabilitation in primary progressive multiple sclerosis. . Neurol Res Int. 2011; 2011:740505.
A multidisciplinary approach optimises the intermediate and long-term medical, psychological and social outcomes in this population. Restoration and maintenance of functional independence and societal reintegration, and issues relating to quality of life are addressed in rehabilitation processes.
Amtmann D, Cook KF, Johnson KL, et al. The PROMIS initiative: involvement of rehabilitation stakeholders in development and examples of applications in rehabilitation research. Arch Phys Med Rehabil. 2011; 92(10 Suppl):S12-9.
This article provides an overview of the involvement of rehabilitation stakeholders in the development of sound measurement tools for the Patient-Reported Outcomes Measurement Information System (PROMIS), a National Institutes of Health-funded initiative. PROMIS is a multisite study that included many different populations.
Rota V, Perucca L, Simone A, et al. Walk ratio (step length/cadence) as a summary index of neuromotor control of gait: application to multiple sclerosis. Int J Rehabil Res. 2011; 34(3):265-9.
In patients with MS, the walk ration (WR) is a disability-sensitive index of neuromotor control of gait, and thus a promising outcome measure for treatments aimed at improving motor coordination.
Tefertiller C, Pharo B, Evans N, et al. Efficacy of rehabilitation robotics for walking training in neurological disorders: a review. J Rehabil Res Dev. 2011; 48(4):387-416.
The authors conducted a literature search of original articles to identify all studies that examined the use of robotic devices for restoring walking function in adults with neurological disorders including MS.
Courtney AM, Castro-Borrero W, Davis SL, et al. Functional treatments in multiple sclerosis. Curr Opin Neurol. 2011;24(3):250-4.
This review focuses on recent advances in the understanding and management of a wide range of symptoms and dysfunctions associated with MS.
Sacco R, Bussman R, Oesch P, et al. Assessment of gait parameters and fatigue in MS patients during inpatient rehabilitation: a pilot trial. J Neurol. 2011; 258(5):889-94.
The aim of this study was to characterise spatio-temporal gait parameters by a simple and easy-to-use gait analysis system (GAITRite(®)) in MS patients compared with healthy controls, and to analyse changes and correlation with fatigue during inpatient rehabilitation.
Judica E, Martinelli Boneschi F, Ungaro D, et al. Impact of fatigue on the efficacy of rehabilitation in multiple sclerosis. J Neurol. 2011; 258(5):835-9.
The aim of this study was to investigate if an intensive, short-term inpatient rehabilitation program is able to improve fatigue in MS, and if fatigue is able to negatively influence the clinical and functional outcome of rehabilitation in MS.
Broekmans T, Roelants M, Alders G, et al. Exploring the effects of a 20-week whole-body vibration training programme on leg muscle performance and function in persons with multiple sclerosis. J Rehabil Med 2010; 42(9):866-72.
A randomized controlled trial to investigate the acute effects of long-term whole-body vibration on leg muscle performance and functional capacity in persons with multiple
sclerosis. It was concluded that the applied 20-week whole-body vibration exercise protocol did not improve leg muscle performance or functional capacity in mild- to moderately impaired persons with MS.
Mattioli F, Stampatori C, Bellomi F, et al. Neuropsychological rehabilitation in adult multiple sclerosis. Neurol Sci 2010; 31 Suppl 2:S271-4.
It was found that intensive and specific training of attention, information processing and executive functions is significantly effective in ameliorating both neuropsychological treated functions and in reducing depression
Rasova K, Feys P, Henze T, et al. Emerging evidence-based physical rehabilitation for Multiple Sclerosis - Towards an inventory of current content across Europe. Health Qual Life Out 2010; 8 art. No 76.
Paper initiates an analysis of currently applied physical interventions for people with MS throughout Europe during inpatient or outpatient rehabilitation programs. A study of the content of rehabilitation may show presently performed treatment methods revealing the basic considerations that nowadays guide clinicians implicitly or explicitly in the treatment of persons with multiple sclerosis. Following this first step, comparative studies can be set up.
Khan F, Gray O. Disability management and rehabilitation for persons with multiple sclerosis. Neural Reg Res 2010; 5 (4):301-309.
Article presents the current literature on symptomatic treatment and rehabilitation for persons with multiple sclerosis. A comprehensive multidisciplinary approach addresses the acute, intermediate and long-term medical, psychological and social issues faced by these individuals.
Kelleher KJ, Spence W, Solomonidis S, et al. Ambulatory rehabilitation in multiple sclerosis. Disabil Rehabil 2009; 31 (20):1625-1632.
Review summarises the primary factors affecting ambulation and highlights available treatment methods and reviews studies that have attempted to characterise gait deficits within this patient population. Also examines approaches, which may serve to support and maintain ambulation within this patient group for as long as possible.
Carpinella I, Cattaneo D, Abuarqub S, et al. Robot-based rehabilitation of the upper limbs in multiple sclerosis: Feasibility and preliminary results. J Rehabil Med 2009; 41 (12):966-970.
A preliminary evaluation of the feasibility of a robot-based rehabilitation protocol for the improvement of upper limb motor co-ordination in a group of patients with multiple sclerosis. The preliminary results of this pilot study suggest that robot therapy can be applied to patients with multiple sclerosis in a clinical setting and may be beneficial for reduction of the upper limb motor co-ordination deficit
Burks JS, Bigley GK, Hill HH. Rehabilitation challenges in multiple sclerosis. Ann Indian Acad Neur 2009; 12 (4): 296-306.
Reviews the importance of rehabilitation in MS and highlights the significance of an integrated team of healthcare professionals to address areas such as symptom management, secondary disabilities, maintaining good relationships, and quality of life.
Grasso MG, Pace L, Troisi E, et al. Prognostic factors in multiple sclerosis rehabilitation. Eur J Phys Rehab Med 2009; 45 (1): 47-51.
Aims to evaluate the effectiveness of inpatient multidisciplinary rehabilitation treatment in MS and identify reliable prognostic factors. Concludes that a multidisciplinary rehabilitative approach should be recommended for patients with a short disease duration and a relatively moderate disability.
Kraft GH, Johnson KL, Yorkston K, et al. Setting the agenda for multiple sclerosis rehabilitation research. Mult Scler 2009; 14(9):1292-1297.
In 2004 the National Multiple Sclerosis Society (NMSS) convened an expert opinion panel, reviewed evidence-based MS rehabilitation research, and published the paper on the web. It was concluded that much of the MS rehabilitation carried out was based on experience, with little research backing it up. Largely as a result of the conclusions of the expert opinion paper, the NMSS convened a conference of a large number of MS and rehabilitation experts in New York in May, 2005. This conference made many recommendations of ways to increase the quantity and quality of MS research.
Khan F, Pallant JF, Brand C, et al. Effectiveness of rehabilitation intervention in persons with multiple sclerosis: A randomised controlled trial. J Neurol Neurosurg Psych 2008; 79 (11) 1230-1235
In this twelve-month study, 101 people with MS received an individualised rehabilitation program and where compared against people with MS who were on a waitlist. More than 70% of people on the program improved across a range of functional independence measures compared with the waitlist group. The study concludes that an individualised rehabilitation program reduces disability in people with MS, compared with no intervention
Khan F, Pallant JF, Turner-Stokes L. Use of goal attainment scaling in inpatient rehabilitation for persons with multiple sclerosis. Arch Phys Med Rehabil 2008; 89 (4): 652-659
Study investigates effectiveness of the use of goal attainment scaling in inpatient rehabilitation for people with MS compared with standard measures used to evaluate progress in rehabilitation. Study concludes that goal attainment scaling (GAS) is a responsive and useful outcome measure for the rehabilitation of people with MS, providing added value to standardized outcome measurement.
Khan F, Turner-Stokes L, Ng L, Kilpatrick T. Multidisciplinary rehabilitation for adults with multiple sclerosis. Cochrane Database Syst Rev 2007; 18(2): CD006036
Systematic review of controlled trials found 'strong evidence' that inpatient MD rehabilitation can produce short-term gains in activity and participation for people with MS. ‘Limited evidence’ found that outpatient or home-based rehabilitation programmes improve symptoms and disability. Strong evidence was found that longer-term, low intensity programmes improve quality of life. No convincing evidence for cost-effectiveness, or for type or length of therapy was found. It highlights the limitations of RCTs in rehabilitation settings and need for better designed randomized and multiple centre trials.
Chard S E. Community neurorehabilitation: a synthesis of current evidence and future research directions. Neuro Rx 2006; 3(4): 525-34
Review of current evidence about multidisciplinary community neurorehab, with a focus on physiotherapy and occupational therapy.
Grasso MG, Troisi E, Rizzi F, Morelli D, Paolucci S. Prognostic factors in multidisciplinary rehabilitation treatment in multiple sclerosis: an outcome study. Mult Scler 2005; 11(6): 719-24.
230 people admitted to an inpatient rehab ward were assessed using a range of outcome measures. Poor prognostic indicators included severe sphinteric disturbance and severe cognitive impairment. Results of the study show intensive rehab benefits most people with MS and early treatment may aid functional recovery.
Rasova K, Krasensky J, Hardova E, Obenberger J, Seidel Z, Dolezal O et al. Is it possible to actively and purposely make use of plasticity and adaptability in the neurorehabilitation treatment of multiple sclerosis patients? A pilot project. Clin Rehabil 2005; 19(2): 170-81.
Compared people with MS receiving rehatbilitation with a control group, on a range of assessment measures and fMRI scans. Clinical and symptomatic improvements were observed in the treatment group but these were not associated with any clear changes in fMRI observations.
Craig J, Young CA, Ennis M, Baker G, Boggild M. A randomised controlled trial comparing rehabilitation against standard therapy in multiple sclerosis patients receiving intravenous steroid treatment. J Neurol Neurosug Psychiatry 2003; 74(9): 1225-30.
Compared people receiving IV steroids and multidisciplinary rehabilitation with those receiving IV steroids and normal care. Found that combining multidisciplinary rehabilitation with steroids improved outcomes on a range of assessment measures.
Slade A, Tennant A, Chambelain MA. A randomised controlled trial to determine the effect of intensity of therapy upon length of stay in a neurological rehabilitation setting. J Rehabil Med 2002; 34(6): 260-6.
Compared intensive inpatient therapy with normal therapy on a mixed group. People who received intensive therapy showed an average 14-day reduction in length of stay compared with the normal group.
Turner-Stokes L, Williams H, Abraham R. Clinical standards for specialist community rehabilitation services in the UK. Clin Rehabil 2001; 15(6): 611-23.
Sets out proposed clinical standards for community rehab services.
Freeman JA, Langdon DW, Hobart JC, Thompson AJ. Inpatient rehabilitation in multiple sclerosis: do the benefits carry over into the community? Neurology 1999; 52(1): 50-6.
Followed 50 patients after discharge into the community. Benefits from rehabilitation were partly maintained but declined over time, reinforcing the need for continuity of care between inpatient and community settings.
Mathiowetz V, Matuska KM. Effectiveness of inpatient rehabilitation on self-care abilities of individuals with multiple sclerosis. Neurorehabilitation 1998; 11(2): 141-51
1 week of rehabilitation improved people’s ability to self-care; equipment use continued in the majority of patients, and all expressed satisfaction with occupational therapy services.
Solari A, Fillippini G, Gasco P, Colla L, Salmaggi A, LaMantia L, et al. Physical rehabilitation has a positive effect on disability in multiple sclerosis patients. Neurology 1999; 52(1): 57-62.
25 people with MS received inpatient rehabilitation compared with exercises at home. Over time, the inpatient group showed more improvement in disability on a range of assessment measures and on health-related quality of life.
DiFabio RP, Soderberg J, Choi T, Hansen CR, Schapiro RT. Extended outpatient rehabilitation: its influence on symptom frequency, fatigue, and functional status for persons with progressive multiple sclerosis. Arch Phys Med Rehabil 1998;79(2):141-6.
20 people with progressive MS received treatment compared with 20 controls, of 1 day per week rehabilitation over 1 year. Receiving treatment was found to be a predictor of reduced symptom frequency at 1 year follow-up, and to improve fatigue. Functional loss was less in the treatment group compared with the control group.