WESTPORT, CT (Reuters Health) Feb 13 - Measures of mobility, gait, and balance improve significantly in patients with multiple sclerosis (MS) after an 8-week course of physiotherapy, report investigators in Cardiff, Wales. Benefits are relatively short-lived, the researchers find, suggesting that therapy should be ongoing in order to sustain improvement or prevent deterioration.
Dr. C. M. Wiles, of the University of Wales College of Medicine, and associates randomized the order in which 40 patients received each of three experimental courses. For physiotherapy at home or in a hospital outpatient setting, two physiotherapy sessions were administered per week, 45 minutes each, for 8 weeks. The third course consisted of no physiotherapy. All treatment periods were separated by 8 weeks.
The home-based physiotherapy sessions focused more on specific functional activities and the hospital-based program was aimed more at specific facilitation. However, there appeared to be no significant difference in benefit between the two types of therapy, the investigators write in the February issue of the Journal of Neurology, Neurosurgery & Psychiatry.
Changes in the Rivermead mobility index were significant and similar for the two physiotherapy types compared with no treatment. Balance score and time, as well as measures of walking, improved with active treatment. Patients and their care providers perceived better mobility and a reduced tendency to fall after physiotherapy.
"Whether this study will promote better access to physiotherapy for patients with MS and chronic disability remains to be seen," Dr. Wiles told Reuters Health. "It would certainly be unfortunate if all available resources for MS patients were to be put into the newer disease modifying drugs at the expense of supportive therapies."
He added, "I suggest there needs to be an approach which, as well as trying to limit disease progression, also aims to optimize and preserve the functional abilities of patients who are already limited by disability."
J Neurol Neurosurg
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