The Multiple Sclerosis Achievement Center: A Maintenance Rehabilitation Approach Toward a Chronic Progressive Form of the Disease

Schapiro, Randall T.; Soderberg, Judy; Hooley, Mary; Terry, Gail; Ruhsam, Sharon; Linroth, Ronna; Hatgidakis, Rev. John; Hall, Sheila

doi:10.1177/136140968800200104

Cited by 6 publications

(7 citation statements)

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“…The results of this study showed that patients with MS who participated in a comprehensive outpatient rehabilitation program experienced less fatigue. Similar results had been previously obtained by Di Fabio et al [7] in a different study based on a "maintenance" rehabilitation program [26], and later referred as "extended" outpatient rehabilitation [7]. This study differs from ours because it was not randomized, the control group was located in a waiting list, the duration of treatment and the assessment methods were different.…”

Section: Discussionsupporting

confidence: 86%

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The impact of outpatient rehabilitation on quality of life in multiple sclerosis

Patti¹,

Ciancio²,

Reggio³

et al. 2002

Journal of Neurology

101

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It is well accepted that rehabilitative treatment can be effective in reducing disability and optimizing quality of life (QoL) of people with multiple sclerosis (MS). The aim of this study was to evaluate the effects of a comprehensive outpatient rehabilitative treatment on QoL in patients suffering from MS. We selected 111 patients from a sample of 407 patients who had consecutively entered the MS Center of Catania (which is located in southern Italy) in 1998. Fifty-eight were randomly assigned to the study treatment and 53 to a waiting list (control treatment). Kurtzke's EDSS and quality of Life (QoL)were the primary endpoints. QoL was measured with the generic multi-item SF-36 scales. We also used: the Beck Depression Inventory (BDI) for depression, the Tempelaar Social Experience Check-list (SET) for social activities and the Fatigue Impact Scale (FIS). The study treatment group was treated for 6 consecutive weeks, 6 days a week with a comprehensive rehabilitative outpatient model. The control treatment group was in a waiting list and was trained to self-exercises at home. EDSS remained unchanged in both groups. All health related QoL domains significantly improved in the study treatment (p < 0.001 in physical functioning, role physical, bodily pain, general health, and social functioning; p < 0.05 in vitality, role emotional and mental health). FIS, SET and BDI also improved significantly after the rehabilitative treatment in the study group (p < 0.001). The results of this study confirm the effectiveness of a short comprehensive outpatient model of rehabilitative treatment in people with MS and in particular in their QoL.

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Section: Discussionsupporting

confidence: 86%

“…Previously Shapiro and associates developed a "maintenance" rehabilitation program used as "extended" home outpatient rehabilitation [26]. This rehabilitation program produced substantial benefit in persons with chronic progressive MS [7].…”

Section: Introductionmentioning

confidence: 99%

The impact of outpatient rehabilitation on quality of life in multiple sclerosis

Patti¹,

Ciancio²,

Reggio³

et al. 2002

Journal of Neurology

101

View full text Add to dashboard Cite

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“…Here we see that both groups continued to improve during the at-home phase of the study. In a related study, Di Fabio, et al, found that patients with progressive MS who continued with an extended home outpatient rehabilitation over the course of 1 year experienced a lower rate of decline in physical function when compared with subjects who did not exercise [ 70 , 71 ]. Our study did not compare subjects who had performed the extended exercise protocol with any who had exercised and stopped.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive neuromodulation to improve gait in chronic multiple sclerosis: a randomized double blind controlled pilot trial

Tyler

Kaczmarek

Rust

et al. 2014

J NeuroEngineering Rehabil

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BackgroundThis study sought to examine the effect of targeted physical therapy with and without cranial nerve non-invasive neuromodulation (CN-NINM), on the walking ability of people with MS who exhibited a dysfunctional gait. We hypothesized that subjects who received electrical stimulation would have greater improvement than those who had a control device after a 14-week intervention. Gait disturbance is a common problem for people with multiple sclerosis (MS). Current management may include exercise, pharmacology, functional electrical stimulation, compensatory strategies, use of assistive devices, and implanted electrical devices. We have developed an effective rehabilitative strategy using neuromodulation of the cranial nerves via electrical stimulation of the tongue to enhance the plasticity of the brain.MethodsThe study is a within-subject blinded randomized control design. Twenty chronic MS subjects with an identified gait disturbance were assigned to either an active or control group. Both groups completed a 14-week intervention program using a standardized combination of exercise and a device that provided electrical stimulation to the tongue. Those in the active group received electrical stimulation on the tongue that they could perceive. Those in the control group used a device that did not provide a physiologically significant stimulus and was not perceivable. Subjects were assessed with the Dynamic Gait Index (DGI).ResultsThe DGI scores improved for both groups. There were significant between-group differences, with the active group showing statistically greater improvement than the control group mean.ConclusionPeople with MS demonstrated improved gait with CN-NINM training in a pilot randomized controlled trial. This study suggests that tongue-based neurostimulation may amplify the benefits of exercise for improving gait in people with chronic MS.

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“…The management of these aspects of care may not be feasible in the context of an inpatient model. Considering this Shapiro et al [27] developed a "maintenance" rehabilitation program which could be regarded as "extended" home outpatient rehabilitation. This extended exposure to rehabilitation (5 hours, 1 day a week for one year) produced substantial benefit in patients with chronic progressive MS.…”

Section: Discussionmentioning

confidence: 99%

Effects of a short outpatient rehabilitation treatment on disability of multiple sclerosis patients

et al. 2003

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It is well known that neurorehabilitation can reduce disability or improve handicap of people with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of a short period (6 weeks) of a tailored, individualised outpatient rehabilitation program in people with progressive MS. A randomised-controlled trial was undertaken in patients with primary and secondary progressive MS referred to the Centro Sclerosi Multipla of Catania. One hundred and eleven patients were assessed at baseline and at 12 weeks with validated measures of disability (Functional Independence Measure (FIM)) and impairment (Expanded Disability Status Scale (EDSS) and Functional Systems Scale). Of the 111, 58 were randomly assigned to the treatment group and 53 to the control group. All patients had been previously trained in a home exercise program. Both groups were well matched for age, sex, disease duration and severity, disability and quality of life (Short Form-36). At the end of 6 weeks patients allocated to the rehabilitation treatment group showed significant improvement in their level of disability compared with the control group,while the level of impairment did not change. Thirty-two patients of the treatment group and four of the control group improved on the FIM by two or more steps at 12 weeks (p<0.0001). An improvement by 1 EDSS step occurred in only two patients of the treatment group and in one patient of the control group. Benefits were maintained for a further six weeks. This study demonstrates that a short outpatient rehabilitation treatment improves disability of MS patients, without changing their impairment and confirms the effectiveness of rehabilitation in people with MS.

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The Multiple Sclerosis Achievement Center: A Maintenance Rehabilitation Approach Toward a Chronic Progressive Form of the Disease

Cited by 6 publications

References 0 publications

The impact of outpatient rehabilitation on quality of life in multiple sclerosis

The impact of outpatient rehabilitation on quality of life in multiple sclerosis

Non-invasive neuromodulation to improve gait in chronic multiple sclerosis: a randomized double blind controlled pilot trial

Effects of a short outpatient rehabilitation treatment on disability of multiple sclerosis patients

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