Multidisciplinary rehabilitation for adults with multiple sclerosis.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Trials

Background:

• Multidisciplinary rehabilitation (MD) is crucial for symptomatic and supportive care in Multiple Sclerosis (MS).
• Existing evidence for the effectiveness of MD rehabilitation in MS requires further establishment.

Purpose of the Study:

• To evaluate the effectiveness of organized MD rehabilitation in adults diagnosed with MS.
• To identify specific rehabilitation approaches and settings that yield positive outcomes for MS patients.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (CENTRAL, MEDLINE, CINAHL, PEDro, EMBASE, etc.) up to 2005.
• Included randomized and controlled clinical trials comparing MD rehabilitation with standard care or varying intervention intensities.
• Methodological quality was assessed by three reviewers, followed by a 'best evidence' synthesis, grouping trials by setting, type, and duration.

Main Results:

• Seven high-quality RCTs and one CCT involving 747 MS patients were analyzed.
• Inpatient MD rehabilitation showed short-term improvements in activity and participation, without affecting impairment levels.
• Outpatient/home-based high-intensity programs offered short-term symptom and disability improvements, while low-intensity, long-duration programs demonstrated long-term quality of life benefits.

Conclusions:

• MD rehabilitation enhances the experience of individuals with MS by improving activity and participation, but does not modify impairment.
• Regular evaluation and assessment for rehabilitation are recommended for MS patients.
• Further research is essential to determine optimal rehabilitation intensity, frequency, cost-effectiveness, and to improve the methodological rigor of clinical trials.