Ecker D, Mauch E, Sabolek M
Fachklinik für Neurologie Dietenbronn, Akademisches Krankenhaus der Universität Ulm, Dietenbronn 7, 88477, Schwendi, Deutschland.
Nervenarzt. 2013 Feb;84(2):197-201. doi: 10.1007/s00115-012-3677-4.
The concept of multimodal complex treatment combines treatment by physicians with intensive conservative treatment. The therapy duration is often 14-21 days. Investigations showing the benefit of this treatment for multiple sclerosis patients are currently missing.
A total of 220 patient records were retrospectively analyzed with respect to the Barthel index, the expanded disability status scale (EDSS) score and early rehabilitation assessment (Frühreha-Assessment). Subgroup analysis was used to examine variations in clinical severity, age and disease duration.
The motor subscore was improved (p = 0.031) in the total sample. The subgroup analysis showed that in particular patients with an average disease duration (11-20 years) and age (41-60 years) showed the greatest benefits. In addition to the group of moderately affected patients the group of severely affected patients (Barthel index 36-64 and < 35) also showed an improvement in the Barthel index.
Multimodal complex treatment for MS patients can lead to a significant improvement in motor abilities and reduction of the need of nursing. In particular intermediately affected patients showed the strongest improvement in contrast to the results of the current appraisal of the German Medical Review Board of the Health Insurance Funds (MDK).
多模式综合治疗的概念将医生的治疗与强化保守治疗相结合。治疗周期通常为14 - 21天。目前尚缺乏表明这种治疗对多发性硬化症患者有益的研究。
对220份患者记录进行回顾性分析，评估巴氏指数、扩展残疾状态量表（EDSS）评分和早期康复评估（Frühreha - Assessment）。采用亚组分析来研究临床严重程度、年龄和病程的差异。
总样本的运动子评分有所改善（p = 0.031）。亚组分析表明，特别是疾病平均病程（11 - 20年）和年龄（41 - 60岁）的患者受益最大。除中度受影响患者组外，重度受影响患者组（巴氏指数36 - 64和< 35）的巴氏指数也有所改善。
对多发性硬化症患者进行多模式综合治疗可显著改善运动能力并减少护理需求。特别是中度受影响的患者与德国医疗保险基金医学审查委员会（MDK）当前评估结果相比改善最为明显。
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