Document Detail


Prognostic factors in multidisciplinary rehabilitation treatment in multiple sclerosis: an outcome study.
MedLine Citation:
PMID:  16320734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 (beta = -0.32, P <0.001), cognitive status (beta = -0.15, P <0.05) and disease duration (beta = -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 (beta = -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.
Authors:
M G Grasso; E Troisi; F Rizzi; D Morelli; S Paolucci
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Multiple sclerosis (Houndmills, Basingstoke, England)     Volume:  11     ISSN:  1352-4585     ISO Abbreviation:  Mult. Scler.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-02     Completed Date:  2006-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9509185     Medline TA:  Mult Scler     Country:  England    
Other Details:
Languages:  eng     Pagination:  719-24     Citation Subset:  IM    
Affiliation:
Fondazione Santa Lucia-IRCCS, Rome, Italy. mg.grasso@hsantalucia.it
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adult
Disability Evaluation
Female
Humans
Male
Middle Aged
Multiple Sclerosis, Chronic Progressive / rehabilitation*
Patient Care Team / organization & administration*
Prognosis
Program Evaluation
Regression Analysis
Rehabilitation Centers / organization & administration*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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