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Panel Outlines Benefits of Different Types of Rehabilitation for People with MS But “We need more Knowledge,” Write the Authors

December 8, 2015

Summary
  • A panel of experts convened by the American Academy of Neurology (AAN) conducted an extensive review of more than 100 published studies focusing on rehabilitation in MS.
  • Among its findings, the panel concluded that there is moderate evidence for probable benefits of weekly in-home or outpatient physical therapy for improving balance, disability and gait for people with all forms of MS, and weaker evidence for other techniques.
  • The authors state that for many of the trials reviewed benefits were difficult to determine due to flaws in the study designs.
  • The authors note that the most important conclusion of this extensive systematic review is the need for well-designed trials of rehabilitation therapies and techniques.
  • The National MS Society has accelerated research breakthroughs in the field of MS rehabilitation, and is making exercise and physical activity a key target in a groundbreaking wellness initiative.
  • The review is published in Neurology (2015;85:1896–1903). Summaries have been developed by the AAN for people with MS and clinicians.
Background: Rehabilitation can help people with MS to achieve their physical, psychological, social and vocational potential. But to convince doctors and insurers that rehabilitation really does help, we need the kind of evidence that can only come from carefully designed and conducted scientific studies.
 
The American Academy of Neurology, the world’s largest association of neurologists and neuroscience professionals,  assembled an expert panel to review published scientific studies on rehabilitation in MS. The panel reviewed 142 articles, addressing whether comprehensive multidisciplinary rehabilitation, outpatient or inpatient physical therapy, or other techniques and programs minimize impairment, reduce disability, or improve health-related quality of life for people with MS:
 
The Report: The panel came to the following conclusions:
  • Weekly home or outpatient physical therapy for 8 weeks probably is effective for improving balance, disability, and gait in people with MS who are able to walk 5 meters with or without an assistive device
  • Individualized inpatient exercise (3 weeks) followed by home exercises (15 weeks) possibly is effective for reducing disability
  • Motor and sensory balance training (3 weeks) possibly is effective for improving balance
  • Data are inadequate to support or refute the use of many other programs and techniques, including short-term aerobic exercise programs, group exercise therapy, strength training, whole body vibration exercise training, aquatic exercise training, cooling garments, intermittent transcranial magnetic stimulation, and balance-based torso weighting, among others. 
The review is published in Neurology (2015;85:1896–1903). Summaries are available for people with MS and clinicians.
 
Next Steps:  The authors note that the most important conclusion of this extensive review is the need for well-designed trials of rehabilitation therapies and techniques. “We need more knowledge about how to integrate rehabilitation efficiently across the MS continuum,” they write.
 
The National MS Society has accelerated research breakthroughs in the field of MS rehabilitation, funding some of the first results showing the benefits of exercise in people with MS, establishing a fellowship program to recruit and train talented clinician-scientists in MS rehabilitation research, and making exercise and physical activity a key target in a groundbreaking wellness initiative.
 
Read more about the benefits of exercise
 
Read more about rehabilitation research

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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