Influence of a Complex Rehabilitation Process on Quality of Life in Patients With Multiple Sclerosis
Volume 14, Issue 1 (2024)
Volume 14, Issue 1 (2024)
Influence of a Complex Rehabilitation Process on Quality of Life in Patients With Multiple Sclerosis
Abstract:
Patients with multiple sclerosis (MS) have a lower quality of life (QoL) than the general population. Rehabilitation
is an essential part of the comprehensive treatment of MS patients. The aim was to determine the influence of complex
physical therapy on the QoL of MS patients and the association of functional status with certain domains of health-related
QoL. We followed 58 MS patients. The complex kinesitherapy used the Bobath concept and occupational therapy with the
use of robot-assisted rehabilitation for the upper extremities. Before the start of rehabilitation and at the end, functional
status was assessed by the Expanded Disability Status Scale (EDSS) and Berg Balance Scale (BBS). QoL was assessed
through the standardized SF36 test and summarized into two scores: physical health component score and mental health
component score. The average age of patients was 49.38 years. There was a significant improvement in all patients after
the therapy, both in functional status and in QoL. There were no significant correlations between the EDSS and BBS with
QoL parameters (individual SF36 categories and two summary scores). Duration of the disease correlated with the EDSS
and BBS, but not with QoL. The age of patients did not correlate with functional status or with QoL. Physical therapy improves
both functional status and QoL, but improvements do not correlate. There is a need to incorporate QoL assessment
into assessments of disease severity, progression, and treatment success to obtain the most relevant results in creating the
right treatment strategy.
Keywords:
Functional status, Neurodegenerative Diseases, Occupational Therapy, Physical therapy
Full Text:
References:
Abreu-Corrales, A., Velasco, A., Cuesta-Gómez, A., & Sánchez-González, J. L. (2023). Impact of reflex locomotion and the Bobath concept
on clinical and biomolecular parameters in people with multiple sclerosis: study protocol for a randomized controlled trial. Frontiers
in neurology, 14, 1209477.
Ayvat, E., Doğan, M., Ayvat, F., Kılınç, Ö. O., Sütçü, G., Kılınç, M., & Yıldırım, S. A. (2024). Usefulness of the Berg Balance Scale for prediction
of fall risk in multiple sclerosis. Neurological sciences: official journal of the Italian Neurological Society and of the Italian
Society of Clinical Neurophysiology, 10.1007/s10072-024-07318-w.
Barin, L., Salmen, A., Disanto, G., Babačić, H., Calabrese, P., Chan, A., Kamm, C. P., Kesselring, J., Kuhle, J., Gobbi, C., Pot, C., Puhan, M.
A., von Wyl, V., & Swiss Multiple Sclerosis Registry (SMSR) (2018). The disease burden of Multiple Sclerosis from the individual and
population perspective: Which symptoms matter most? Multiple sclerosis and related disorders, 25, 112–121.
Calandri, E., Graziano, F., Borghi, M., & Bonino, S. (2017). Coping strategies and adjustment to multiple sclerosis among recently diagnosed
patients: the mediating role of sense of coherence. Clinical rehabilitation, 31(10), 1386–1395.
Carnero Contentti, E., Genco, N. D., Hryb, J. P., Caspi, M., Chiganer, E., Di Pace, J. L., López, P. A., Lessa, C., Caride, A., & Perassolo, M.
(2017). Impact of multiple sclerosis on quality of life: Comparison with systemic lupus erythematosus. Clinical neurology and neurosurgery,
163, 149–155.
Caselli, S., Sabattini, L., Cattaneo, D., Jonsdottir, J., Brichetto, G., Pozzi, S., Lugaresi, A., & La Porta, F. (2023). When ‘good’ is not good
enough: a retrospective Rasch analysis study of the Berg Balance Scale for persons with Multiple Sclerosis. Frontiers in neurology,
14, 1171163.
Castelli, L., Giovannini, S., Iacovelli, C., Fusco, A., Pastorino, R., Marafon, D. P., Pozzilli, C., & Padua, L. (2022). Training-dependent plasticity
and far transfer effect enhanced by Bobath rehabilitation in Multiple Sclerosis. Multiple sclerosis and related disorders, 68, 104241.
Cattaneo, D., Jonsdottir, J., & Repetti, S. (2007). Reliability of four scales on balance disorders in persons with multiple sclerosis. Disability
and rehabilitation, 29(24), 1920–1925.
Centonze, D., Leocani, L., & Feys, P. (2020). Advances in physical rehabilitation of multiple sclerosis. Current opinion in neurology, 33(3),
255–261.
Cohen, M., Bresch, S., Thommel Rocchi, O., Morain, E., Benoit, J., Levraut, M., Fakir, S., Landes, C., & Lebrun-Frénay, C. (2021). Should we
still only rely on EDSS to evaluate disability in multiple sclerosis patients? A study of inter and intra rater reliability. Multiple sclerosis
and related disorders, 54, 103144.
Dalgas, U., Stenager, E., Jakobsen, J., Petersen, T., Hansen, H. J., Knudsen, C., Overgaard, K., & Ingemann-Hansen, T. (2009). Resistance
training improves muscle strength and functional capacity in multiple sclerosis. Neurology, 73(18), 1478–1484.
Finlayson, M. L., Peterson, E. W., & Cho, C. C. (2006). Risk factors for falling among people aged 45 to 90 years with multiple sclerosis.
Archives of physical medicine and rehabilitation, 87(9), 1274–1287.
Gervasoni, E., Jonsdottir, J., Montesano, A., & Cattaneo, D. (2017). Minimal Clinically Important Difference of Berg Balance Scale in People
with Multiple Sclerosis. Archives of physical medicine and rehabilitation, 98(2), 337–340.e2.
Gil-González, I., Martín-Rodríguez, A., Conrad, R., & Pérez-San-Gregorio, M. Á. (2020). Quality of life in adults with multiple sclerosis: a
systematic review. BMJ open, 10(11), e041249.
Giovannoni, G., Turner, B., Gnanapavan, S., Offiah, C., Schmierer, K., & Marta, M. (2015). Is it time to target no evident disease activity
(NEDA) in multiple sclerosis? Multiple sclerosis and related disorders, 4(4), 329–333.
Gitman, V., Moss, K., & Hodgson, D. (2023). A systematic review and meta-analysis of the effects of non-pharmacological interventions on
quality of life in adults with multiple sclerosis. European journal of medical research, 28(1), 294.
Ilett, P., Lythgo, N., Martin, C., & Brock, K. (2016). Balance and Gait in People with Multiple Sclerosis: A Comparison with Healthy Controls
and the Immediate Change after an Intervention based on the Bobath Concept. Physiotherapy research international: the journal for
researchers and clinicians in physical therapy, 21(2), 91–101.
Isaković, J., Gorup, D., & Mitrečić, D. (2019). Molecular mechanisms of microglia- and astrocyte-driven neurorestoration triggered by application
of electromagnetic fields. Croatian medical journal, 60(2), 127–140.
Kremenchutzky, M., & Walt, L. (2013). Perceptions of health status in multiple sclerosis patients and their doctors. The Canadian journal of
neurological sciences. Le journal canadien des sciences neurologiques, 40(2), 210–218.
Krieger, S. C., Antoine, A., & Sumowski, J. F. (2022). EDSS 0 is not normal: Multiple sclerosis disease burden below the clinical threshold.
Multiple sclerosis (Houndmills, Basingstoke, England), 28(14), 2299–2303.
Kubsik-Gidlewska, A. M., Klimkiewicz, P., Klimkiewicz, R., Janczewska, K., & Woldańska-Okońska, M. (2017). Rehabilitation in multiple
sclerosis. Advances in clinical and experimental medicine: official organ Wroclaw Medical University, 26(4), 709–715.
Kwolek, A., Podgórska, J., & Rykała, J. (2010). Own experience in the rehabilitation of multiple sclerosis patients. Przegląd Medyczny
Uniwersytetu Rzeszowskiego, 2, 213–220.
Lada A. (2010). Diagnostics and neurological therapy in the light of the NDT- Bobath concept. Prakt Fizjo Rehab, 4, 30–34.
Lozinski, B. M., & Yong, V. W. (2022). Exercise and the brain in multiple sclerosis. Multiple sclerosis (Houndmills, Basingstoke, England),
28(8), 1167–1172.
Lysandropoulos, A. P., Havrdova, E., & ParadigMS Group (2015). ‘Hidden’ factors influencing quality of life in patients with multiple sclerosis.
European journal of neurology, 22 Suppl 2, 28–33.
Matsuda, P. N., Shumway-Cook, A., Ciol, M. A., Bombardier, C. H., & Kartin, D. A. (2012). Understanding falls in multiple sclerosis: association
of mobility status, concerns about falling, and accumulated impairments. Physical therapy, 92(3), 407–415.
Mazumder, R., Murchison, C., Bourdette, D., & Cameron, M. (2014). Falls in people with multiple sclerosis compared with falls in health
controls. PloS one, 9(9), e107620.
McKay, K. A., Tremlett, H., Fisk, J. D., Zhang, T., Patten, S. B., Kastrukoff, L., Campbell, T., Marrie, R. A., & CIHR Team in the Epidemiology
and Impact of Comorbidity on Multiple Sclerosis (2018). Psychiatric comorbidity is associated with disability progression in multiple
sclerosis. Neurology, 90(15), e1316–e1323.
Meyer-Moock, S., Feng, Y. S., Maeurer, M., Dippel, F. W., & Kohlmann, T. (2014). Systematic literature review and validity evaluation of the
Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients with multiple sclerosis.
BMC neurology, 14, 58.
Morales, R.deR., Morales, N.deM., Rocha, F. C., Fenelon, S. B., Pinto, R.deM., & Silva, C. H. (2007). Qualidade de vida em portadores de
esclerose múltipla [Health-related quality of life in multiple sclerosis]. Arquivos de neuro-psiquiatria, 65(2B), 454–460.
Nilsagård, Y., Gunn, H., Freeman, J., Hoang, P., Lord, S., Mazumder, R., & Cameron, M. (2015). Falls in people with MS--an individual data
meta-analysis from studies from Australia, Sweden, United Kingdom and the United States. Multiple sclerosis (Houndmills, Basingstoke,
England), 21(1), 92–100.
Nilsagård, Y., Lundholm, C., Denison, E., & Gunnarsson, L. G. (2009). Predicting accidental falls in people with multiple sclerosis -- a longitudinal
study. Clinical rehabilitation, 23(3), 259–269.
Padgett, P. K., & Kasser, S. L. (2013). Exercise for managing the symptoms of multiple sclerosis. Physical therapy, 93(6), 723–728.
Post M. W. (2014). Definitions of quality of life: what has happened and how to move on. Topics in spinal cord injury rehabilitation, 20(3),
167–180.
Raine S. (2007). The current theoretical assumptions of the Bobath concept as determined by the members of BBTA. Physiotherapy theory and
practice, 23(3), 137–152.
Reich, D. S., Lucchinetti, C. F., & Calabresi, P. A. (2018). Multiple Sclerosis. The New England journal of medicine, 378(2), 169–180.
Rothwell, P. M., McDowell, Z., Wong, C. K., & Dorman, P. J. (1997). Doctors and patients don’t agree cross sectional study of patients’ and
doctors’ perceptions and assessments of disability in multiple sclerosis. BMJ (Clinical research ed.), 314(7094), 1580–1583.
Saguil, A., Farnell Iv, E. A., & Jordan, T. S. (2022). Multiple Sclerosis: A Primary Care Perspective. American family physician, 106(2),
173–183.
Simpson, M., & Macdonell, R. (2015). The use of transcranial magnetic stimulation in diagnosis, prognostication and treatment evaluation in
multiple sclerosis. Multiple sclerosis and related disorders, 4(5), 430–436.
Visschedijk, M. A., Uitdehaag, B. M., Klein, M., van der Ploeg, E., Collette, E. H., Vleugels, L., Pfennings, L. E., Hoogervorst, E. L., van der
Ploeg, H. M., & Polman, C. H. (2004). Value of health-related quality of life to predict disability course in multiple sclerosis. Neurology,
63(11), 2046–2050.
Walton, C., King, R., Rechtman, L., Kaye, W., Leray, E., Marrie, R. A., Robertson, N., La Rocca, N., Uitdehaag, B., van der Mei, I., Wallin,
M., Helme, A., Angood Napier, C., Rijke, N., & Baneke, P. (2020). Rising prevalence of multiple sclerosis worldwide: Insights from
the Atlas of MS, third edition. Multiple sclerosis (Houndmills, Basingstoke, England), 26(14), 1816–1821.
White, L. J., & Castellano, V. (2008). Exercise and brain health--implications for multiple sclerosis: Part 1--neuronal growth factors. Sports
medicine (Auckland, N.Z.), 38(2), 91–100.
Wilski, M., Gabryelski, J., Brola, W., & Tomasz, T. (2019). Health-related quality of life in multiple sclerosis: Links to acceptance, coping
strategies and disease severity. Disability and health journal, 12(4), 608–614.
Woszczak M. (2005). Physiotherapeutic procedures in multiple sclerosis. Polski Przegląd Neurologiczny, 1,130–133.
Ysrraelit, M. C., Fiol, M. P., Gaitán, M. I., & Correale, J. (2018). Quality of Life Assessment in Multiple Sclerosis: Different Perception
between Patients and Neurologists. Frontiers in neurology, 8, 729.
