Contributions
Abstract: EP1394
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Multidisciplinary rehabilitation (MDR) can be effective in improving functional recovery and quality of life (QoL) in persons with multiple sclerosis (pwMS). The identification of possible predictors of inpatient MDR efficacy on the short-term is important to optimize the access priority and to assess the cost/benefit profile of this intervention.
Materials and methods: We retrieved clinical charts of pwMS admitted to our Neurorehabilitation Unit from July,1st, 2011 to June, 30th, 2016. Subjects' demographics, disease duration, disease phenotype, modified Barthel Index (mBI), Expanded Disability Status Scale (EDSS), pain numerical rating score (NRS), types of intervention administered (motor, occupational, speech/swallowing, respiratory, cognitive, psychological) were collected in a single database. All clinical scales were rated at admission and discharge. Using a multivariate logistic regression analysis, we assessed whether clinical and demographics at baseline, as well as the number of interventions, were predictors of MDR effects. Improvement at discharge was defined as follows: for mBI an increase of at least 5 points, for EDSS a 1.0 decrease for baseline score ≤5.5 and 0.5 for baseline scores >5.5; for pain NRS any decrease.
Results: We collected data from 653 pwMS, with a median disease duration of 15 years. Most of pwMS had a progressive (52.5% secondary (SP) and 17.5% primary (PP)) and 30% had a relapsing-remitting (RR) disease course. At admission, median EDSS was 6.5 and mBI 63. At discharge, 65% and 22% of patients improved for mBI and EDSS, respectively, NRS decreased in 89% of them. mBI improvement was significantly associated with a disease duration shorter than 15 years and with access to psychological counseling. EDSS improvement was associated with baseline EDSS scores higher than 6.5, disease duration shorter than 15 years, RR course, female gender and longer duration of the admission period. Pain NRS improvement was associated with higher scores at admission and psychological counseling.
Conclusions: Inpatient MDR improved autonomy in activities of daily living in the majority of admitted pwMS. The effect seems to be more pronounced in female subjects with shorter disease duration. More comprehensive scales and measures reflecting QoL changes are needed to capture the actual effectiveness of inpatient MDR.
Disclosure: Elisabetta Groppo: nothing to disclose.
Alessio Signori: nothing to disclose.
Maria Pia Sormani: nothing to disclose.
Cristina Grosso: nothing to disclose.
Davide Cattaneo: nothing to disclose.
Marco Rovaris: nothing to disclose.
Abstract: EP1394
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Multidisciplinary rehabilitation (MDR) can be effective in improving functional recovery and quality of life (QoL) in persons with multiple sclerosis (pwMS). The identification of possible predictors of inpatient MDR efficacy on the short-term is important to optimize the access priority and to assess the cost/benefit profile of this intervention.
Materials and methods: We retrieved clinical charts of pwMS admitted to our Neurorehabilitation Unit from July,1st, 2011 to June, 30th, 2016. Subjects' demographics, disease duration, disease phenotype, modified Barthel Index (mBI), Expanded Disability Status Scale (EDSS), pain numerical rating score (NRS), types of intervention administered (motor, occupational, speech/swallowing, respiratory, cognitive, psychological) were collected in a single database. All clinical scales were rated at admission and discharge. Using a multivariate logistic regression analysis, we assessed whether clinical and demographics at baseline, as well as the number of interventions, were predictors of MDR effects. Improvement at discharge was defined as follows: for mBI an increase of at least 5 points, for EDSS a 1.0 decrease for baseline score ≤5.5 and 0.5 for baseline scores >5.5; for pain NRS any decrease.
Results: We collected data from 653 pwMS, with a median disease duration of 15 years. Most of pwMS had a progressive (52.5% secondary (SP) and 17.5% primary (PP)) and 30% had a relapsing-remitting (RR) disease course. At admission, median EDSS was 6.5 and mBI 63. At discharge, 65% and 22% of patients improved for mBI and EDSS, respectively, NRS decreased in 89% of them. mBI improvement was significantly associated with a disease duration shorter than 15 years and with access to psychological counseling. EDSS improvement was associated with baseline EDSS scores higher than 6.5, disease duration shorter than 15 years, RR course, female gender and longer duration of the admission period. Pain NRS improvement was associated with higher scores at admission and psychological counseling.
Conclusions: Inpatient MDR improved autonomy in activities of daily living in the majority of admitted pwMS. The effect seems to be more pronounced in female subjects with shorter disease duration. More comprehensive scales and measures reflecting QoL changes are needed to capture the actual effectiveness of inpatient MDR.
Disclosure: Elisabetta Groppo: nothing to disclose.
Alessio Signori: nothing to disclose.
Maria Pia Sormani: nothing to disclose.
Cristina Grosso: nothing to disclose.
Davide Cattaneo: nothing to disclose.
Marco Rovaris: nothing to disclose.