October 7, 2003
A comprehensive rehabilitation program added to treatment with intravenous methylprednisolone improves the outcome of patients experiencing a multiple sclerosis (MS) relapse, British investigators report.
Although both interventions are believed to be of benefit, clinical evidence supporting physical and occupational therapy is lacking, Dr. Jenny Craig and colleagues note in the September issue of the Journal of Neurology, Neurosurgery and Psychiatry.
They therefore conducted a randomized controlled trial of standard treatment with steroids versus steroid treatment plus multidisciplinary team assessment and treatment. The study cohort was MS patients being treated for relapse at the Walton Centre for Neurology and Neurosurgery in Liverpool.
Twenty patients in each group completed their assigned treatment and were available for follow-up. The multidisciplinary treatment included patient education, physical therapy, bladder management, and provision of mobility aids.
After 3 months of treatment, scores on the 60-point Guy's Neurological Disability Scale improved by a mean of 8.0 points in the active treatment group and by 1.75 in the control group (p < 0.030). Mean change scores on the Amended Motor Club Assessment were 13.0 and 6.40, respectively (p = 0.035).
Thus, the Dr. Craig's team concludes, the active treatment group exhibited improved motor function and reduced disability that were "clinically and functionally relevant to the subjects."
J Neurol Neurosurg Psychiatry 2003;74:1225-1230
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