Abstract

Objective: A stratified, randomized, 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, randomized to a treatment group (n=49) for individualized rehabilitation programme, or a control waitlist group (n=52). Functional Independence Measure (FIM) was used to assess ¡¥activity¡¦, while 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<.001). There was a clinical and statistically significant improvement in FIM (Motor) total scores (p<.001), and the FIM Motor domains of : transfer (p<.001), locomotion (p<.001), self care (p<.001), and the FIM cognitive subscale (p<.016). In the treated group 70.8% improved, compared with 13% of the controls. Significantly more patients in the control group deteriorated over the study period (58.7% versus 16.7%: p<.001). There were no differences between control and treatment group scores on the MSIS-Physical (p=.18), MSIS-Psychological (p=.45) or GHQ subscales.

Conclusion: An individualized rehabilitation programme reduces disability in persons with MS compared to no intervention. The impact of rehabilitation on QoL needs further evaluation. More information on effectiveness of the various components of the multidisciplinary rehabilitation programmes are now needed.