Outcomes of inpatient rehabilitation of patients with multiple sclerosis

Abstract

Background: Several trials have demonstrated improved outcomes following inpatient rehabilitation for Multiple Sclerosis patients. Two populations were studied: patients in relapse and patients with no active medical problems recruited from the community. In every day practice, most admissions for MS inpatient rehabilitation aim to improve function following sudden deterioration. The outcomes of inpatient rehabilitation for this population were never studied. Method: Retrospective case note analysis of consecutive admissions of MS patients from 2005 to 2009 to a specialist neurological rehabilitation unit.Results: Forty-one cases were identified. 26 were females. Age 25-71 (mean 52 ± 12). Disease duration 0-39 years (mean 13 ± 11). 20 patients were admitted from the community and 21 were transferred from acute hospital beds. Length of stay ranged between 11 to 152 days (mean 49 ± 36). Mean length of stay for wheelchair dependent patients was approximately double the length of stay for ambulatory patients. Improving mobility, transfer or posture were the primary cause of admissions in 37 cases. Sixteen out of 21 ambulatory patients (76%) attained 100% mobility goals. Only 4 out of 20 wheelchair bound patients (20%) achieved 100% mobility goals (P 0.002). Neither the type of MS nor the duration of it influenced the overall outcome. Conclusion: Our results suggest that MS patients admitted for rehabilitation following deterioration secondary to a medical or surgical cause show the same favourable outcome that was demonstrated with MS stable patients or in relapse. Baseline mobility, but not type and duration of MS, seems to have a significant impact on the rehabilitation outcome in terms of gaol achievement.

Improvement of gait and balance in patients with multiple sclerosis after multidisciplinary physical rehabilitation: Analysis of real-world data in Russia

“…The impact of the disease duration is somewhat contradictory. In the study of Gaber et al (2010), no relationship was found between the disease duration and the achievement of rehabilitation goals. In this study, the assessment of benefit was made based on the achievement of 2013) patients with a longer disease duration had a poorer response to rehabilitation, that corresponds with finding of our study.…”

Association between disease-modifying therapies for multiple sclerosis and healthcare utilisation on a population level: a retrospective cohort study

“…So although hospitalisation rates have decreased over time, it appears that those individuals who are hospitalised are sicker, and require more complex care 13. It is also possible that some individuals with MS remain in hospital longer as they wait for placement in a long-term care facility, or are receiving inpatient rehabilitation 36…”

Rehabilitation Outcomes in Multiple Sclerosis Patients on Ocrelizumab Diagnosed With West Nile Virus Encephalitis

“…Commonly cited benefits following inpatient rehabilitation include decreased fatigue, improved walking speed, and improved quality of life in MS patients [14,15]. Mobility is the most frequently reported area of improvement for patients with MS following a course of inpatient rehabilitation; however, baseline mobility is the most important predictive factor as to whether a patient will attain mobility goals [16][17][18][19]15]. Shorter disease course, longer rehabilitation length of stay (LOS), female sex, and relapsing subtype may be associated with better rehabilitation outcomes [20].…”