Most, but not all, ICF activities and participation categories of the ICF Core Sets for MS could be confirmed from the perspective of persons with MS. It is worth considering to add category 'd920 Recreation and leisure' to the Brief ICF Core Set.

The helpful components of both in-patient and out-patient rehabilitation that are of particular importance to people with MS are diverse and show the relevance of ICF in rehabilitation and the need for a comprehensive view in rehabilitation. The importance of peers and peer support should be taken into account in rehabilitation planning and related recommendations. The findings show that helpful rehabilitation for people with MS is not a set of mechanistic interventions but requires good social relationships and support. Implications for Rehabilitation Helpful components of rehabilitation for people with MS are diverse and show the need for a comprehensive and individual view in rehabilitation. Professionally guided peer support should be offered as a part of rehabilitation. Interventions related to assistive technology and home adaptations should be an obvious part of rehabilitation. It is important to support people with MS to preserve identity as an active person and to take personal responsibility in their own rehabilitation.

Background: Few multidisciplinary rehabilitation studies with a heterogeneous design have focused on people with multiple sclerosis (MS). This study compared subjective-reported changes in performance and satisfaction with daily activities among moderately and severely disabled people with MS during a 2-year, multidisciplinary, group-based, outpatient rehabilitation program comprising education in self-management and compensatory techniques, exercise, and guided peer support. Methods: Thirty-eight adults with moderate disability (Expanded Disability Status Scale [EDSS] score of 4.0–5.5, 74% women, mean age of 48 years) and 41 persons with severe disability (EDSS 6.0–8.5, 63% women, mean age of 48 years) were assessed at baseline and after 12 and 21 months of outpatient rehabilitation using the Canadian Occupational Performance Measure. Group × time interactions were analyzed using mixed analysis of variance. Participants’ explanations of reasons for changes in activity performance were collected via semistructured interviews and content analyzed. Results: Statistically significant improvements in Canadian Occupational Performance Measure performance and satisfaction scores were reported in both groups from baseline to 21 months of rehabilitation. No significant between-group differences in improvement were observed. The self-reported reasons for improvement were mainly linked to environmental factors. Conclusions: The outpatient rehabilitation program, including four themes—cognition, mood, energy conservation, and body control—improved the self-reported performance of patients with MS with moderate and severe disabilities. Environmental factors warrant consideration during rehabilitation.