A standardized outpatient physical rehabilitation program improves walking in people with multiple sclerosis presenting with different levels of disability: a retrospective study
Author(s):
G. Loyola
,
G. Loyola
Affiliations:
C. Santoyo
,
C. Santoyo
Affiliations:
M. Janer
,
M. Janer
Affiliations:
D. Fàbregas
,
D. Fàbregas
Affiliations:
S. Sánchez
,
S. Sánchez
Affiliations:
X. Sibera
,
X. Sibera
Affiliations:
J. Sastre-Garriga
,
J. Sastre-Garriga
Affiliations:
I. Galán
,
I. Galán
Affiliations:
X. Montalban
X. Montalban
Affiliations:
ECTRIMS Online Library. Santoyo C. Sep 15, 2016; 147001; 146
Carmen Santoyo
Carmen Santoyo
Contributions
Abstract

Abstract: 146

Type: Oral

Abstract Category: RIMS - Exercise

Background: Walking capacity is one of the most valuable body functions among persons with multiple sclerosis (MS) and it is one of the most frequently affected. To address this restriction, different physical rehabilitation programs have been implemented with no consensus regarding their effectiveness.

Objective: To report on the effectiveness of an integrated tailored physical rehabilitation program on walking ability in people with multiple sclerosis categorized according to their level of neurological disability.

Methods: Retrospective data were examined and analyzed. Data were obtained from all patients with an EDSS ≤ 6.5 who were admitted at the Neurorehabilitation Unit of Cemcat along two consecutive years, 2014 and 2015. Patients carried out a 5 months ambulatory rehabilitation period, three times per week. The standardized physical therapy group sessions included three major components modified according to the patient"s specific impairment and functional needs: muscular training (strengthening and stretching), balance training (standing and fitball) and gait reeducation strategies. Balance and gait outcome measures included: 10 meter walking test (10MWT), Tinetti Test (TT) and Berg Balance Scale (BBS) measured before and after the rehabilitation program. Patients were categorized into mild (EDSS≤4; n=22), moderate (EDSS 4.5-5.5; n=80) and severe (EDSS ≥6; n=62) walking disability. Minimally clinical significant differences (MCSC) were established: 20% for the 10MWT, 1 point for the TT and 4 points for the BBS (as per previous literature).

Results: One hundred and sixty four people with MS (44.2% men) were included, with a mean age of 50.96 (SD ±11.13) and a median EDSS of 5.0; 57.6% had relapsing-remitting MS, 23.6% had secondary progressive MS and 18.2% had a primary progressive form. All three clinical outcome measurements demonstrated statistically significant improvements after the intervention. In the whole sample, BBS showed MSCSC in 42.7% of subjects (mean improvement 44.62-48.15), 10MWT in 32.7% (mean improvement: 14.1-12.31 sec) and TT in 32.7% (mean improvement: 8.24-8.88).

Conclusions: In the reported cohort, an ambulatory goal-directed physical rehabilitation program on ambulation is effective in people with multiple sclerosis presenting with different impairment levels to improve walking disability in a range of outcome measures.

Disclosure: The authors have nothing to disclose

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies