A Short-Term, Multidisciplinary, Intensive Inpatient Neurorehabilitation Program for Multiple Sclerosis Patients with Moderate Disability: A Pilot Study

Abstract

Intensive inpatient neurorehabilitation may be an effective form of intervention for people with multiple sclerosis (MS) to supplement treatment with disease-modifying agents. The primary objective of this study was to evaluate the tolerability and safety of a personalized, one-on-one, short-term, intensive inpatient neurorehabilitation program for MS patients with moderate disability. Thirty MS patients (diagnosed using Polman criteria) with moderate disability as indicated by Expanded Disability Status Scale (EDSS) score of 5.0 to 6.5 were enrolled in a 4-week intensive inpatient neurorehabilitation program. The primary outcome measures were tolerability and safety. Secondary outcome measures were impairment, disability/activity, handicap/participation, fatigue, and quality of life. The results showed good tolerability, with only three patients (10%) developing transitory neuromuscular fatigue; and safety, with adverse events observed in only six patients (20%). Significant improvement was found in impairment and disability/activity as measured by the Scripps Neurological Rating Scale (P = .000) and the EDSS (P = .001), respectively. The Multiple Sclerosis Quality of Life–54 showed improvement in physical (P = .008) and mental health (P = .026), and the Fatigue Impact Scale showed improvement in fatigue (17 patients) (P = .005). This pilot study demonstrated good tolerability and safety of the short-term inpatient intensive neurorehabilitation program. Impairment, disability/activity, quality of life, and fatigue were improved at the completion of the program. Sustained improvement remains to be determined in future clinical trials.