Activity limitations and participation restrictions in people with multiple sclerosis: a detailed 10-year perspective

Abstract

Aim: To conduct a detailed investigation into changes in activity limitations and participation restrictions over 10 years in people with mild, moderate and severe multiple sclerosis. Methods: This study was a 10-year longitudinal study of 264 people with multiple sclerosis living in Stockholm County, Sweden. Ten-year changes in personal and instrumental activities in daily living were assessed using the Katz Activities in Daily Living Index Extended and participation in social/lifestyle activities using the Frenchay Activities Index. Results: While people with moderate multiple sclerosis, compared to baseline, demonstrated significantly higher proportions of dependency in most activities of personal and instrumental activities in daily living at the 10-year follow-up, the mild group primarily increased their dependency in instrumental activities and the severe group in personal activities. Significantly higher proportions of the moderate group showed restricted participation in domestic and outdoor activities whereas the mild group only showed restrictions in a few domains of participation. A majority of people with severe multiple sclerosis showed restricted participation in all social/lifestyle activities at baseline and the 10-year follow-up. Conclusions: Prominent long-term increases in activity limitations and participation restrictions occurred across the spectrum of disease severity but was most pronounced in those more moderately affected. ä IMPLICATIONS FOR REHABILITATION This study provides guidance with regard to specific activities that are prone to deteriorate across 10 years and thereby reflect important targets and outcomes for interventions. Increases in activity limitations and participation restrictions were most pronounced in those moderately affected by multiple sclerosis. Those mildly affected by multiple sclerosis primarily increased their dependency in instrumental activities of daily living while those severely affected increased their dependency in personal activities of daily living.

Inability to Work Fulltime, Prevalence and Associated Factors Among Applicants for Work Disability Benefit

“…Work ability reflects the extent to which people can do their job satisfactorily, taking their job demands and their (physical and mental) health into account [6]. Having a chronic disease, associated with activity limitations, can lead to decreased mental and physical functioning [7][8][9], and therefore threatening work ability and working hours [10][11][12]. In comparison to healthy workers, workers with a chronic disease work fewer hours and more often parttime due to differences in fatigue and emotional exhaustion [13][14][15].…”

Role of Rehabilitation in Promoting Engagement in Daily Life in Multiple Sclerosis

“…In a prospective cohort research, changes in activity limitation and participation over a period of 10 years were studied in a Swedish population of persons with MS. 17 Results indicated that people in the mild stages of MS showed restrictions in a few domains of participation, whereas the moderate group experienced restricted participation in domestic and outdoor activities and most of the individuals with severe MS showed restricted participation in all social/lifestyle activities. Over time, an increase in participation restrictions was present across all MS groups, but mostly in the moderate group.…”

Disabled in Society - A Scoping Review on Persons Living with Multiple Sclerosis and Disability

“…As time passes since a person is diagnosed with MS, impairment will eventually debut and increase. 6 , 19 A longitudinal study found that over a 10-year period, many persons with MS’s capacity to participate in activities and society decreased. 19 Although there is no cure for MS, studies have showed positive outcomes in the social participation of persons with MS attending multidisciplinary rehabilitation.…”

“… 6 , 19 A longitudinal study found that over a 10-year period, many persons with MS’s capacity to participate in activities and society decreased. 19 Although there is no cure for MS, studies have showed positive outcomes in the social participation of persons with MS attending multidisciplinary rehabilitation. 20 , 21 This scoping review seeks to contribute to clinical practice by highlighting the societal barriers and discrimination that persons with MS face.…”