The Effect Of Walking Impairment Of Multiple Sclerosis Patients On Caregiver Burden

Background: Mobility impairment is one of the most disabling conditions in Multiple Sclerosis (MS) patients, affecting a variety of aspects of patients such as independence, employment, mental health and quality of life (QOL). In addition, the chronic and disabling nature of MS can have also significant negative effects on family dynamics and, therefore, MS caregivers are at high risk of psychological and even physical morbidity. The critical role of MS caregivers is becoming increasingly recognized. Since research on MS has focused primarily on patient QOL, very little is known about the QOL of people caring for patients with this disease. 

Objectives: This study was designed to determine the impact of walking impairment of MS patients which is discrepant according to the disability level on the burden and QOL of their caregivers.

Methods: 772 MS patients were recruited, 47 MS patients and their 47 caregivers finished the study. Expanded Disability Status Scale (EDSS), Patient Determined Disease Step Scale (PDSS), MS Walking Scale-12 (MSWS-12), MS International QOL Questionnaire (MUSIQOL), MS Impact Scale (MSIS-29); Caregiver Burden Interview (CBI), Caregiver QOL in MS Scale (CAREQOL-MS), General Self-Efficacy Scale (GSES), Satisfaction with Life Scale (SLS). Results were compared on disability level (EDSS: 2.0- 3.5, n=17; EDSS: 4.0-6.5, n=30).

Results: Patients with higher disability had significantly worse scores on the MSWS-12, MUSIQOL, MSIS-29, and PDSS (p<0.001, p=0.015, p=0.004, and p<0.001, respectively). The caregivers facing with higher disability had significantly worse scores on CBS (p<0.001) and CAREQOL (p=0.002). A significant correlations between EDSS, MSWS-12, MUSIQOL, MSIS-29, PDSS, CBS, and CAREQOL-MS scores of patients and caregivers were noted (p<0.05).

Conclusions: The impairments on disability level, walking and QOL of MS individuals were related to OQL declines and increased burden of their caregivers. Therefore, it may be important to provide acceptable education and support strategies with individual intervention while defining the needs and goals of the MS patients and their caregivers to improve the rehabilitation success.