Guest Editorial

Abstract

Guest Editorials T he RIMS (Rehabilitation in Multiple Sclerosis) network is now approaching its 30th anniversary, in 2021. It is a pleasure to look back, with so many others, to the discipline of rehabilitation in general, and developments witnessed in rehabilitation for persons with multiple sclerosis (MS). Rehabilitation in general has evolved to an evidencebased discipline. The importance, specificity, and rigor of scientific research in rehabilitation sciences have been highlighted, relatively recently, by the establishment of the Cochrane Rehabilitation Field (see https://rehabilitation.cochrane.org/). Rehabilitation research is now also substantial in the area of MS, with evidence being summarized in a plenitude of systematic reviews on different themes. 1 However, multidisciplinary and updated guidelines to guide clinicians, therapists, and health care managers are so far lacking. 2 The most comprehensive formally developed guideline was published by NICE (National Institute for Health and Care Excellence), United Kingdom (see https://www.nice.org.uk/guidance/cg186), in 2014 but could benefit from more specificity. In addition, an EMSP (European Multiple Sclerosis Platform)-RIMS publication was distributed in 2012 with an expert overview (editor Thomas Henze; see https://www.eurims.org/News/recommendations-onrehabilitation-services-for-persons-with-multiple-sclerosis-in-europe.html). Consulting the APPECO database for recent evidence is also enlightening, as addressed in an article in this theme issue of the International Journal of MS Care (IJMSC). However, implementation of evidence in clinical practice remains a challenge. First of all, the MS Barometer of EMSP (see http://www.emsp.org/projects/ ms-barometer/) illustrated that many countries lack sufficient specialized so-called tertiary care rehabilitation services for persons with MS, which limits equity of receipt of optimal rehabilitation and care. Access to specialized care was sometimes called a "regional lottery." Also, access to primary care was often poor for persons with MS, who sometimes received the label of chronically disabled, thus relying on social welfare regulations rather than health care. The RIMS organization was originally founded in 1991 as a network of MS centers predominantly at a tertiary care level. The European project MARCH (Multiple Sclerosis And Rehabilitation, Care and Health Services in Europe) had the mission to share clinical expertise in rehabilitation amongst specialized centers in