The benefit of inpatient neurorehabilitation in multiple sclerosis

Abstract

The role of an inpatient neurorehabilitation unit in the management of multiple sclerosis (MS) remains unclear. A necessary first step is the demonstration of benefit in those who are admitted. In order to address this question, 79 patients with MS admitted over a 16-month period for multidisciplinary rehabilitation were studied using assessment scales as measures of disability and handicap. Fourteen patients were recovering from a recent relapse and the remaining 65 were in the progressive phase of the disease. The patients were clinically assessed and rated on admission and discharge using Kurtzke's Disability Status Scale (DSS), the Barthel Index (BI) and the Environmental Status Scale (ESS). A statistically significant functional improvement was seen in 65% of patients as determined by the Barthel Index and 44% improved on the ESS. Improvement was most marked in those in whom a reduction in impairment had occurred during recovery from relapse but also occurred in 63% of those who had not changed neurologically. These results suggest a beneficial effect from admission to a neurorehabilitation unit for patients with MS, including those in the progressive phase of the disease, although its role in the long-term management of MS remains to be defined.