Effects of inpatient rehabilitation in multiple sclerosis patients with moderate disability

The aim of this study was to evaluate the effects of 3 weeks of inpatient neurorehabilitation for multiple sclerosis (MS) patients with moderate disability and to determine the clinical usefulness of different outcome measures. Rehabilitation consisted of physiotherapy, occupational therapy and consultation by speech therapist, social worker and psychologist. Subjects were assessed in two cohorts. Cohort A (n = 40) was assessed on admission and discharge during a rehabilitation period. Cohort B (n = 18) was assessed 3 weeks before admission, on admission and at discharge. Mean Expanded Disability Status Scale score was 5.7 +/- 0.7 at admission for both cohorts combined. Different motor functions, personal care ability and quality of life were assessed. Improvements (p < 0.05) were seen in the health-related quality of life (HRQoL) domains mental health, general health and vitality/fatigue of SF-36. Improvements (p < 0.05) in physical measures such as mobility and standing balance in cohort A, walking speed in cohort B and hand/arm dexterity both cohorts were found. No significant changes were seen in grip strength, personal care ability or fatigue in any cohort. The Barthel Index of ADL seems to have a ceiling effect and the Fatigue Severity Scale seems to be insensitive. In conclusion, improvements were seen after 3 weeks of inpatient rehabilitation in motor functions, some aspects of HRQoL and disability after 3 weeks of inpatient rehabilitation.