Physical Therapy and MS: One Size Does Not Fit All

Background: Rehabilitation for multiple sclerosis patients is an essential part of treatment, particularly for those with progressive disease and accumulating disability. It is widely believed that comprehensive rehabilitation directed toward the specific needs of MS patients can reduce disability related to fatigue, motor performance, and frequency of falls, and leads to improvement in quality of life. However, quantifying the benefits of rehab services in MS is challenging because not all rehabilitation programs are equal. Total Rehab and Fitness (TRF), an outpatient comprehensive multidisciplinary rehabilitation program specifically designed for MS patients, focuses on evidence-based rehabilitation services and exercise programs to improve the quality of life for patients with MS. In the TRF model, patients continue with the physical therapy and medical gym program indefinitely. Although there is some data showing that 6 – 8 weeks of comprehensive multidisciplinary rehabilitation is possibly effective for improving disability, there is no data from outpatient programs using a continuous treatment model.

Objectives: To describe a program of ongoing comprehensive rehabilitation that is targeted specifically towards MS patients and to review outcomes in 10 patients treated for 12 months.

Methods: Total Rehab and Fitness and The Elliot Lewis Center for Multiple Sclerosis Care assessed fatigue and mobility on 10  MS patients referred for therapy. Ability to adhere to the program, fatigue, fall frequency, and walking assessments,  including 25ft, and 6-minute walk tests, were measured at 13 week intervals.

Results: Self-reported outcomes include improvements in fatigue and endurance, frequency of falls, and overall quality of life. Quantitative results on standard measures will be shown in table format.

Conclusions: Comprehensive, specialized rehabilitation can result in sustained improvement in fatigue and walking in MS patients with physical disability. These findings will hopefully lead to further research and an increase in the availability of comprehensive rehabilitation services for MS.  Future studies should focus on other benefits of long term maintenance therapy, as well as fatigue, endurance, and quality of life in MS. Exposure, education, and training of physical therapists early in their career can make this type of essential therapy available to more patients.