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J Neurol Neurosurg Psychiatry 2008;79:1230-1235 doi:10.1136/jnnp.2007.133777
  • Research paper

Effectiveness of rehabilitation intervention in persons with multiple sclerosis: a randomised controlled trial

  1. F Khan1,
  2. J F Pallant2,
  3. C Brand3,
  4. T J Kilpatrick4
  1. 1
    Department of Rehabilitation Medicine, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  2. 2
    School of Rural Health, University of Melbourne, Melbourne, Victoria, Australia
  3. 3
    Department of Clinical Epidemiology and Health Service Evaluation Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  4. 4
    Centre for Neuroscience, The University of Melbourne, Parkville, Victoria, Australia
  1. Dr Fary Khan, Department of Rehabilitation Medicine, University of Melbourne, Royal Melbourne Hospital, Poplar Road Parkville, Melbourne, VIC 3052, Australia; fary.khan{at}mh.org.au
  • Received 30 August 2007
  • Revised 16 April 2008
  • Accepted 5 May 2008
  • Published Online First 5 June 2008

Abstract

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.

Footnotes

  • Competing interests: None.

  • Ethics approval: The study was approved by the research committee of the Royal Melbourne Hospital, Victoria, Australia.

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