Groppo Elisabetta, Signori Alessio, Sormani Maria Pia, Grosso Cristina, Mantia Loredana La, Cattaneo Davide, Rovaris Marco
Multiple Sclerosis Center and Neurorehabilitation Unit, IRCCS Fondazione Don Gnocchi, Italy.
Department of Health Sciences (DISSAL), University of Genoa, Italy.
Mult Scler J Exp Transl Clin. 2019 Apr 16;5(2):2055217319843673. doi: 10.1177/2055217319843673. eCollection 2019 Apr-Jun.
Persons with multiple sclerosis may benefit from hospital-based multidisciplinary rehabilitation.
To investigate the effects of hospital-based multidisciplinary rehabilitation and to identify their potential predictors in a large sample of persons with multiple sclerosis.
From the charts of 655 persons with multiple sclerosis consecutively admitted to our unit, disease profiles, modified Barthel index, Expanded Disability Status Scale (EDSS), pain numerical rating score and type of interventions were retrospectively collected. We defined an improvement at discharge as follows: modified Barthel index increase of at least 5 points, EDSS decrease of 1.0 if baseline score was 5.5 or less and of 0.5 if baseline score was greater than 5.5; any numerical rating score decrease.
After a median admission period of 36 days, at discharge 65%, 22% and 89% of persons with multiple sclerosis improved for modified Barthel index, EDSS and numerical rating score, respectively. The modified Barthel index improvement was associated with shorter disease duration, lower EDSS at baseline and with access to psychological counselling. EDSS improvement was associated with shorter disease duration, relapsing-remitting course, female gender and longer duration of the admission period.
Inpatient multidisciplinary rehabilitation was associated with improved autonomy in activities of daily living in a relevant proportion of persons with multiple sclerosis. The effect seems to be more evident in individuals with shorter multiple sclerosis duration and relapsing-remitting disease course.
多发性硬化症患者可能从基于医院的多学科康复中获益。
在大量多发性硬化症患者样本中，研究基于医院的多学科康复的效果，并确定其潜在预测因素。
从连续入住我们科室的655例多发性硬化症患者的病历中，回顾性收集疾病概况、改良巴氏指数、扩展残疾状态量表（EDSS）、疼痛数字评分以及干预类型。我们将出院时的改善定义如下：改良巴氏指数增加至少5分；若基线评分≤5.5，EDSS降低1.0，若基线评分>5.5，EDSS降低0.5；任何数字评分降低。
中位住院期36天后，出院时分别有65%、22%和89%的多发性硬化症患者在改良巴氏指数、EDSS和数字评分方面有所改善。改良巴氏指数的改善与疾病持续时间较短、基线时较低的EDSS以及接受心理咨询有关。EDSS的改善与疾病持续时间较短、复发缓解型病程、女性性别以及较长的住院期有关。
住院多学科康复使相当一部分多发性硬化症患者的日常生活活动自主性得到改善。这种效果在疾病持续时间较短和复发缓解型病程的个体中似乎更为明显。
