The Danish MS Hospitals, Haslev, Denmark.
Danish Technological Institute, Aarhus, Denmark.
Mult Scler. 2018 Mar;24(3):340-349. doi: 10.1177/1352458517735188. Epub 2017 Oct 6.
There is insufficient evidence to support the effectiveness of multidisciplinary rehabilitation on the health-related quality of life (HRQoL) of MS patients.
To evaluate the longer term effectiveness of inpatient multidisciplinary rehabilitation on the HRQoL of MS patients.
The study was a two-hospital, pragmatic, randomized controlled trial with a 6-month follow-up. Patients aged 18-65 years with MS and Expanded Disability Status Scale scores ≤7.5 were randomly assigned (1:1) to 4 weeks of inpatient multidisciplinary rehabilitation (20 days of scheduled rehabilitation) or 6 months on a wait list. The outcome measures were Functional Assessment in Multiple Sclerosis (FAMS), Multiple Sclerosis Impact Scale-29 (MSIS-29), EQ-5D-5L and 15D.
We randomized 213 patients to the wait-list control group and 214 patients to the treatment group. Trends in favour of the treatment group were observed across all measures. However, the difference was significant in only two of the six measures. The treatment effect was -2.7 (95% CI: -5.6 to (-0.1)), p = 0.046) for the MSIS-29 Psychological and 0.017 (95% CI: 0.005-0.030, p = 0.008) for the 15D. FAMS, which we used to calculate the sample size, was not significant.
The results indicated that inpatient multidisciplinary rehabilitation is effective in improving the HRQoL of MS patients after 6 months.
目前尚无充分证据支持多学科康复对多发性硬化症（MS）患者健康相关生活质量（HRQoL）的有效性。
评估住院多学科康复对 MS 患者 HRQoL 的长期效果。
这是一项为期 6 个月随访的两院区、实用、随机对照试验。将年龄在 18-65 岁之间、扩展残疾状况量表（EDSS）评分≤7.5 的 MS 患者随机分为两组（1:1），分别接受 4 周住院多学科康复治疗（20 天计划康复）或 6 个月候补名单。主要结局指标为功能评估多发性硬化量表（FAMS）、多发性硬化影响量表-29（MSIS-29）、EQ-5D-5L 和 15D。
我们将 213 名患者随机分配至候补名单对照组，214 名患者分配至治疗组。所有指标均显示治疗组呈改善趋势。但只有在其中两个指标中，治疗组与对照组之间存在显著差异。MSIS-29 心理评分的治疗效果为-2.7（95%CI：-5.6 至-0.1），p = 0.046），15D 评分的治疗效果为 0.017（95%CI：0.005-0.030，p = 0.008）。我们用于计算样本量的 FAMS 评分不显著。
结果表明，住院多学科康复治疗在 6 个月后能有效改善 MS 患者的 HRQoL。
