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Intensive interdisciplinary specialized rehabilitation or regular physiotherapy for multiple sclerosis? A randomised
C Bonnyaud1, S Hameau2, R Zory3
1Motion analysis laboratory, Functional Exploration Department, Raymond Poincaré Hospital, GHU Paris Saclay, APHP, 104 Bld Raymond Poincaré, Garches, France; Paris-Saclay University, UVSQ, Research Unit ERPHAN, 104 Bld Raymond Poincaré, Versailles, France.
Interdisciplinary Rehabilitation in an Outpatient Specialised Unit (IROSU) improved secondary outcomes and quality of life in people with Multiple Sclerosis (pwMS) more than community physiotherapy. These benefits were maintained at 6 months, suggesting annual access to IROSU programs for pwMS.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Health Economics
Background:
- The effectiveness of Interdisciplinary Rehabilitation in an Outpatient Specialised Unit (IROSU) for Multiple Sclerosis (MS) patients remains undetermined.
- Comparing IROSU with community-based physiotherapy is crucial for understanding optimal rehabilitation strategies for people with MS (pwMS).
Purpose of the Study:
- To compare the effects of IROSU versus community physiotherapy on impairment, function, and Quality of Life (QoL) in pwMS.
- To evaluate the medico-economic impact of IROSU compared to community-based rehabilitation.
Main Methods:
- A pragmatic, multicentre, parallel randomized controlled trial involving 148 pwMS.
- IROSU included a comprehensive program of balance, stretching, walking, resistance, and endurance training.
- Primary outcome was the 6-Minute Walk Test (6MWT); secondary outcomes included strength, power, fatigue, QoL, anxiety, and depression, assessed at baseline, 4 weeks, and 3/6 months.
Main Results:
- Both groups showed similar improvements in walking distance (6MWT).
- The IROSU group demonstrated significantly greater improvements in knee extensor strength, power output, and physical health-related QoL.
- Quality-adjusted life years and cost-utility ratios favored the IROSU intervention, with benefits sustained at 6 months.
Conclusions:
- While walking distance improvements were similar, IROSU yielded superior gains in secondary functional outcomes and QoL for pwMS.
- The sustained improvements and favorable cost-utility suggest that annual access to IROSU programs should be considered for pwMS.
- The study highlights the potential of specialized interdisciplinary rehabilitation in enhancing the long-term well-being of individuals with MS.
