Arriaza María José, Vazquez Azanzazu, Hernández Teresa, Varillas-Delgado David, Meca-Lallana Virginia
Department of Rehabilitation and Physical Medicine, Hospital Universitario de La Princesa, 28062 Madrid, Spain.
Autonomous University of Madrid, Madrid, Spain.
Mult Scler Int. 2022 Jun 16;2022:7908340. doi: 10.1155/2022/7908340. eCollection 2022.
Functional rehabilitation programs in multiple sclerosis have demonstrated their efficacy in improving fatigue. The assessment of functional impairment, however, is more difficult. The purpose is to assess fatigue and disability as a first study measure and to verify their improvement after a specific functional rehabilitation program. An analytical, longitudinal, prospective, and experimental study was carried out with 51 patients aged 18-55 years, with an Expanded Disability Status Scale (EDSS) between 2 and 6.5 who were being followed up in outpatient clinics of the Rehabilitation Service of La Princesa Hospital. The fatigue and disability outcomes before and after a structured exercise training program were evaluated, with each subject acting as their own control. The variables were measured using the Modified Fatigue Impact Scale (MFIS), Barthel Index (BI), and Functional Independence Scale (FIM). Differences according to recurrent or progressive course of the disease are assessed. Improvement in the FIM scale was observed after the retraining program ( = 0.016) and was maintained in the medium term ( = 0.042). This improvement is not statistically significant in Barthel Index. Improvement in MFIS is observed after the program ( < 0.001) and 4-6 months after the end. Both disease courses experience the same improvements with no statistically significant differences between them. The retraining program improves fatigue and multiple sclerosis-related functionality in the short and medium term. There are no differences according to disease course. Both experience the same positive changes with our intervention.
多发性硬化症的功能康复计划已证明其在改善疲劳方面的有效性。然而，功能障碍的评估则更为困难。目的是将疲劳和残疾作为首要研究指标进行评估，并验证在特定功能康复计划后它们是否有所改善。对51名年龄在18 - 55岁之间、扩展残疾状态量表（EDSS）在2至6.5之间、正在拉普林塞萨医院康复服务门诊接受随访的患者进行了一项分析性、纵向、前瞻性和实验性研究。评估了结构化运动训练计划前后的疲劳和残疾结果，每个受试者都作为自身对照。使用改良疲劳影响量表（MFIS）、巴氏指数（BI）和功能独立性量表（FIM）来测量变量。评估了根据疾病复发或进展过程的差异。再训练计划后观察到FIM量表有改善（ = 0.016），并在中期得以维持（ = 0.042）。在巴氏指数方面，这种改善无统计学意义。计划实施后以及结束后4 - 6个月观察到MFIS有改善（ < 0.001）。两种疾病病程都有相同程度的改善，它们之间无统计学显著差异。再训练计划在短期和中期改善了疲劳以及与多发性硬化症相关的功能。根据疾病病程无差异。在我们的干预下，两者都经历了相同的积极变化。
