Inpatient Rehabilitation Utilization for Medicare Beneficiaries With Multiple Sclerosis

Morley, Melissa; Daras, Laura Coots; Forgues, Angela; Gage, Barbara

doi:10.1016/j.apmr.2012.03.008

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…A physician dealing with a rehabilitative treatment should bear in mind the emotional aspects in PwMS to come back home at the end of each daily session. A recent study showed that PwMS had less functional improvement than other populations using the inpatient rehabilitation setting and the higher rates of depression was found within the MS population [39]. This finding must be an important consideration for rehabilitation service needs in PwMS.…”

Section: Discussionmentioning

confidence: 98%

Inpatient versus outpatient rehabilitation for multiple sclerosis patients: effects on disability and quality of life

Pappalardo¹,

D’Amico²,

Leone³

et al. 2016

Mult Scler Demyelinating Disord

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Background: The most suitable setting of rehabilitation for Persons with Multiple Sclerosis (PwMS) has not been identified so far because there is a general lacking of controlled studies. Aim of this study was to evaluate the treatment efficacy in terms of functional independence between two different settings. Methods: A randomized, wait-list controlled study was performed at the MS Center of the University of Catania, and Rehabilitation Center of the Hospital of Acireale, Italy. Inclusion criteria were: a) range of age 18-75, b) Expanded Disability Status Scale ≥4.0 and ≤8.0 c) self-reported worsening of standing or walking abilities in the last 6 months. The examining physician was blind to patient allocation program. The Functional Independence Measure (FIM), and the 36-Health Survey Questionnaire (SF-36) data were collected at T0 (baseline) and T1 (follow-up). Results: One-hundred forty-six patients were randomly assigned to three groups. Forty-nine PwMS were allocated in the outpatient treatment group (Group A), 49 patients in the inpatients treatment group (Group B) and 48 patients in the control waiting list (Group C). Both Group A and Group B showed a significant improvement in total FIM scores (p = 0.03, p = 0.008; respectively) at T1 compared to T0. No difference was found between Group A and B with regard to the FIM scores in the intergroup analysis. Group A showed significant improvement at T1 compared to T0 in all sub-items of SF-36 (p < 0.05), contrary to Group B. A significant difference in total FIM score between the three groups was found (p = 0.0003). The pairwise comparisons showed a significant difference between Group A vs Group C (p = 0.003) and Group B versus Group C (p = 0.001). Conclusions: Inpatients and oupatients rehabilitation approaches both showed efficacy in improving total FIM score. Outpatient rehabilitation setting seems to be more effective in improving patients QoL.

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Section: Discussionmentioning

confidence: 98%