Effectiveness of rehabilitation in multiple sclerosis relapse on fatigue, self-efficacy and physical activity

Abstract

Relapse of disease is one of the most prominent characteristics of multiple sclerosis. Effectiveness of rehabilitation programmes on fatigue, self-efficacy (SE) and physical activity (PA) has not been investigated so far in context of relapse. The aim of our study was to examine if rehabilitation programme in addition to high-dose methylprednisolone (HDMP) during relapse of disease can influence fatigue, SE and PA more than corticosteroid therapy alone. Patients were randomized in control group receiving only HDMP and experimental group which was in addition included in rehabilitation programme. Outcome measures used were Fatigue Severity Scale (FSS), Multiple Sclerosis Self- Efficacy scale (MSSES), Godin Leisure-Time Exercise Questionnaire (GLTEQ), completed on baseline, 1 and 3 months later. There was no significant change in FSS in both time points, despite different trend seen between groups. The mean MSSES for function and control improved significantly in treatment group after 1 month (807.1 ± 96.8, p = 0.005; 665.3 ± 145.1, p = 0.05) and 3 months (820 ± 83.5, p = 0.004; 720.0 ± 198.2, p = 0.016.) compared to baseline values. The mean GLTEQ score was significantly higher in the treatment group compared to the control at both follow-up time points (45.7 ± 7.6, p < 0.001; 34.3 ± 22.4, p < 0.01). Rehabilitation started along with corticosteroid treatment induced significant improvement in PA compared to HDMP therapy alone. It also influenced noticeable changes in self-efficacy, but effect on fatigue was insufficient.

Multidisciplinary rehabilitation for adults with neuromyelitis optica spectrum disorders: A pilot study

“…The study also suggested that MDR was effective in improving the clinical status of patients with NMOSD in terms of impairments. In the UC group, the EDSS score did not change at 4 weeks and improved at 3 months, which indicated that patients with MNOSD are taking corticosteroids (1 month) and exhibit a certain degree of self-healing ability (3 months) (17). The EDSS score improved at 4 weeks after treatment in the MDR group, which indicated that rehabilitation treatment promotes or speeds up the patient's recovery process.…”

Physical Rehabilitation, An Important Factor On The Treatment Of Multiple Scleroses: A Literature Review

“…The rehabilitation of the MS patients is necessary but also very complex, it requires a personalized and multidisciplinary care. The modern medical treatment is not the only way that can postpone the progressive neurodegenerative processes and still remains unclear up to where this treatment prevents the loss of the functional abilities (Nedeljkovic U et al, 2015).…”

Rehabilitation should be prescribed acutely in motor relapses – Yes

“…The authors reported an improvement of quality of life, physical activity and self-efficacy in PwMS measured at 1 and 3 months post-relapse in favour of the group who received the multidisciplinary rehabilitation. 5,6 In addition, no negative or adverse effects were reported in the group who received the multidisciplinary rehabilitation. 5,6 Furthermore, it is noteworthy to mention evidence provided by retrospectively studies, which reported beneficial effects of postrelapse inpatient rehabilitation in PwMS.…”

“…To our best knowledge, three studies applying a randomised control trial design assessed the effects of post-relapse rehabilitation in PwMS following an acute relapse. [5][6][7] In all three studies, this was provided as multidisciplinary rehabilitation, although with differences in structure and content.…”

“…The authors reported that planned and focused multidisciplinary rehabilitation care during steroid treatment of MS relapse was beneficial in terms of motor function, disability and aspects of quality of life, measured at 3 months after the relapse. 7 In the studies of Nedeljkovic and colleagues, 5,6 multidisciplinary rehabilitation counselling was applied during corticosteroid therapy. This was followed by an intensive acute physical rehabilitation programme starting 6-9 days post-relapse in an outpatient settings.…”