Shedding Light on the Black Box of Rehabilitation: Differential Short- and Long-Term Effects of Multidisciplinary Multiple Sclerosis Rehabilitation

Philipp Trénel, Finn Boesen, Anders Guldhammer Skjerbæk, Thor Petersen, Peter Vestergaard Rasmussen, Michael Nørgaard*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: The study of the effectiveness of multidisciplinary rehabilitation (MDR) and how the symptoms and needs of individuals with multiple sclerosis (MS) interplay with the diversity of MDR interventions is still a conundrum, often referred to as a black box. METHODS: We conducted a partial crossover randomized controlled trial with follow-ups at 1 (discharge), 6, and 12 months. Based on their rehabilitation goals, each patient was categorized into 1 of 5 main focus areas (MFAs) prior to admission: Resilience, Cognitive Function, Energy, Physical Function, and Personal Needs. The Functional Assessment of Multiple Sclerosis (FAMS) instrument scores were the primary outcome. RESULTS: MFA groups varied in age (P =.036), MS type (P =.002), Expanded Disability Status Scale score (P <.001), time since diagnosis (P =.002), and FAMS at baseline (P <.001), as well as in composition and quantity of MDR services. At discharge, significant FAMS improvements were found in all 5 MFA groups (FAMS change?>10.4, P <.05), but the affected subdimensions and persistence of improvements varied among MFA groups. At the 6-month follow-up, estimates of controlled differences in FAMS were 9.9 (P =.001), 5.6 (P =.196), 8.5 (P =.008), –1.4 (P =.548), and 17.9 (P =.012) for the Resilience, Cognitive Function, Energy, Physical Function, and Personal Needs groups, respectively. CONCLUSIONS: This study demonstrated that inpatient MDR improves functioning and health-related quality of life in people with MS; the type, degree, and persistence of the benefits are associated with a patient’s main focus area of rehabilitation, which signifies the importance of the goal-setting process in MDR.

Original languageEnglish
JournalInternational Journal of MS Care
Volume26
Issue numberQ3
Pages (from-to)224-232
ISSN1537-2073
DOIs
Publication statusPublished - May 2024

Bibliographical note

Publisher Copyright:
© 2024 Consortium of Multiple Sclerosis Centers.

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