MS Physical Therapy in Need of Proper Study, Experts Say

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The National Multiple Sclerosis Society announced that a panel of experts led a comprehensive review of 142 published studies addressing rehabilitation in multiple sclerosis (MS), and found evidence suggesting that weekly in-home or outpatient physical therapy offers benefits — but, mostly, it found a lack of well-designed studies into MS rehabilitation therapies and techniques.

The review was published in the journal Neurology under the title, “Summary of comprehensive systematic review: Rehabilitation in multiple sclerosis.

Rehabilitation can be critical to the health and well-being of MS patients, and significantly improve their social and vocational potentials. To take rehabilitation further and for it to be accepted by the medical and insurance industries, however, more evidence is needed from carefully designed and conducted scientific studies.

The American Academy of Neurology (AAN) is the world’s largest association of neurologists and neuroscience professionals. The panel of experts it convened analyzed comparative studies regarding multidisciplinary rehabilitation, outpatient versus inpatient physical therapy, and other techniques and programs that minimize impairment or reduce disability, all with the goal of improving the health-related quality of life for MS patients.

Researchers reported the following conclusions:

  • Weekly home or outpatient physical therapy for eight weeks is likely to improve balance, disability and gait in patients able to walk five meters without assistive devices;
  • Personalized inpatient exercise for three weeks, followed by home exercises for 15 weeks, is possibly effective for reducing disability;
  • Motor and sensory balance training for three weeks is likely to improve patients’ balance.

Despite the identified benefits, authors believe the available data is insufficient to support or refute the use of many other programs and techniques — such as short-term aerobic exercise programs, group exercise therapy, strength training, whole body vibration exercise training, exercise training in water, cooling garments, intermittent transcranial magnetic stimulation, or balance-based torso weighting, among others.

The authors found a pressing need for optimally designed trials of rehabilitation therapies and techniques. The National MS Society is now accelerating research in the field of MS rehabilitation, making exercise and physical activity a fundamental focus of its wellness initiative. The review concluded, “We need more knowledge about how to integrate rehabilitation efficiently across the MS continuum.”

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  1. Betty Beem says:

    I have found pt to be extremely effective. My new neurologist after moving to Houston determined that my left side was considererably weaker than my right. After I began an aggressive water aerobics program. I was able to regain bilateral strength. Two other times I was in pt. Once following a hospital stay, the other for knee and hip OA and strengthening muscle groups affected by MS. I have a variety of home exercises, using different equipment, Wii fit, and swimming pool. I feel this has enabled to be more mobile and to be actively involved in an assortment of activities including playing my violin in a civic orchestra and teaching violin and viola.

    • Pam M. says:

      This year, I had a 2 week inpatient rehab following a 5-day hospital stay. The most difficult thing about rehab was keeping up with the daily schedule. My MS fatigue was already a considerable problem, along with drowsiness from new meds given for my relapse. I did feel I gained some benefit from the exercises I learned, but some days it was just too intense trying to keep up with the PT/OT/RT/ST schedule without adequate breaks in between. They all did their best, but clearly the program was not designed for the multitude and fluctuations of my MS symptoms. My PT was just as frustrated as I was. I look forward to seeing more “optimally designed trials of rehabilitation therapies and techniques” in the near future.

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