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From the Istituto Nazionale Neurologico C. Besta (Drs. Solari, Filippini, Salmaggi, La Mantia, and Eoli, and M. Farinotti), Milan; Ospedale Santo Spirito (Drs. Gasco and Colla), Casale Monferrato (AL); and the Fondazione Clinica Pro Juventute Don C. Gnocchi (Dr. Mendozzi), Milan, Italy.
Address correspondence and reprint requests to Dr. Alessandra Solari, Istituto Nazionale Neurologico C. Besta, Laboratory of Epidemiology, via Celoria 11, 20133 Milan, Italy.
BACKGROUND: Although physical rehabilitation is commonly administered to MS patients, its efficacy has not been established.
OBJECTIVE: We assessed the efficacy of an inpatient physical rehabilitation program on impairment, disability, and quality of life of MS patients with a randomized, single-blind, controlled trial.
METHODS: Fifty ambulatory MS patients were assigned to 3 weeks of inpatient physical rehabilitation (study treatment) or exercises performed at home (control treatment). Patients were evaluated at baseline and at 3, 9, and 15 weeks by a blinded examining physician.
RESULTS: No changes in impairment occurred in either group, as measured by the Expanded Disability Status Scale. At the end of the intervention the study group improved significantly in disability, as assessed by the Functional Independence Measure (FIM) motor domain, compared with controls (p = 0.004), and the improvement persisted at 9 weeks (p = 0.001). The effect size statistic was usually large or moderate in all scale scores of the FIM motor domain at 3 weeks and moderate to fair thereafter. The study group also improved in overall health-related quality of life profile compared with controls; however, the difference was significant only for the mental composite score at 3 (p = 0.008) and 9 weeks (p = 0.001).
CONCLUSIONS: Despite unchanging impairment, physical rehabilitation resulted in an improvement in disability and had a positive impact on mental components of health-related quality of life perception at 3 and 9 weeks.
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