Neurology 1999;52:50
© 1999 American Academy of Neurology
Articles
Inpatient rehabilitation in multiple sclerosis
Do the benefits carry over into the community?
J. A. Freeman, PhD,
D. W. Langdon, PhD,
J. C. Hobart, MRCP and
A. J. Thompson, FRCP
From the Institute of Neurology, London, UK.
Address correspondence and reprint requests to Dr. A.J. Thompson, Institute of Neurology, Neurorehabilitation Section, Queen Square, London WCIN 3BG, UK.
OBJECTIVE: To determine the duration and pattern of carry-over of benefits gained after a short period of multidisciplinary inpatient rehabilitation.
BACKGROUND: Few studies have evaluated the outcome of rehabilitation after discharge. Long-term follow-up is required to establish whether gains made during the inpatient stay are sustained over time and in the patient’s own environment.
METHODS: Prospective single-group longitudinal study. Fifty consecutive patients with progressive MS undergoing inpatient rehabilitation were followed for 12 months after discharge. Assessments were undertaken on admission (A), at discharge, and subsequently at 3-month intervals for 1 year (1Y) with a battery of measures addressing neurologic status, disability, handicap, quality of life, and emotional well-being. The time taken to return to baseline level was calculated using summary measures, and trends in performance levels were plotted.
RESULTS: Twelve-month data were collected for 92% of patients. Although neurologic status declined (median Expanded Disability Status Scale scores: A = 6.8, 1Y = 8.0), improvements were maintained in disability and handicap for 6 months, emotional well-being for 7 months, and health-related quality of life (physical component) for 10 months.
CONCLUSIONS: The benefits gained from rehabilitation were partly maintained after discharge despite worsening neurologic status. Carry-over of benefits, however, declined over time, reinforcing the need for continuity of care between the inpatient setting and the community.
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