Benefits of Physical Therapy Last After MS Patients Return Home
ST. PAUL, MN (January 21, 1999) -- Hospital physical rehabilitation programs have a positive effect on multiple sclerosis patients that lasts after they return home, according to two new studies published in the current issue of Neurology, the scientific journal of the American Academy of Neurology.
One study followed 50 British MS patients for a year after they participated in rehabilitation. Even though the patients' disease symptoms worsened, the rehabilitation improved the patients' ability to function physically and socially for six months. And patients reported a positive effect on their overall quality of life for 10 months.
"This study underlines the importance of rehabilitation in conditions such as MS, which are chronic and progressive," said neurologist and study author Alan J. Thompson, FRCP, of the Institute of Neurology in London.
Thompson said the study points to the need for more coordination among inpatient programs, outpatient care and community services, such as home health care aides. "Although the study showed that the benefits of rehabilitation continued, it also showed that they tended to wear off after a number of months," he said. "In our experience, the strength of the support system patients return to directly impacts the long-term success of the rehabilitation program."
The British study is further supported by an Italian study showing that physical therapy improves MS patients' functioning in daily activities and their quality of life after returning home.
In a 15-week study, 27 MS patients participated in a three-week inpatient physical therapy program, then were taught exercises to do at home. As a control group, another 23 MS patients were taught the home exercises but received no inpatient physical therapy.
The patients were evaluated at the beginning of the study, then after three, nine and 15 weeks. After three weeks, 48 percent of those in physical therapy improved their ability to function in daily activities such as dressing and bathing, compared to 9 percent of those on the home exercise program. At nine weeks, the numbers were 44 percent and 4 percent.
The patients who underwent the physical therapy also reported an improvement in their mental and emotional quality of life three and nine weeks after the study started.
These studies are a step forward in evaluating the effectiveness of rehabilitation for MS patients, according to neurologist Mindy Lipson Aisen, MD, director of rehabilitation research and development at the Veterans Health Administration in Washington, D.C. Few studies have been performed in this area, in part due to the ethical dilemma of limiting treatments for comparison purposes when patients' symptoms flare up.
"With the advent of managed care, there is escalating pressure to document both treatment efficacy and efficiency," Lipson Aisen wrote in an editorial accompanying the two journal articles. "Fortunately, this pressure converges with our motivation to understand the scientific basis of neurorehabilitation. For divergent reasons, we are moving in the right direction."
Improving care for patients with MS and other neurological disorders is the goal of the American Academy of Neurology, an association of more than 15,000 neurologists and neuroscience professionals.
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Editor's Note: Neurology is now published 18 times per year, with two issues in January, March, April, July, September and October. This study is published in the first January issue.
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