Aspects of the formation of an individual rehabilitation program in multiple sclerosis

Abstract

BACKGROUND: Multiple sclerosis (MS) is a progressive nervous system disease that results in the early limitation of life activities and disability in young patients of working age (in 30% of cases, within the first two years of disease onset). Clinical symptoms in the advanced stage of the disease are very polymorphic and become sufficiently persistent and pronounced depending on the course options. The disease progresses to a disorder of the main functions and categories of vital activity, which necessitates socially protecting patients with MS. The primary rehabilitation aim of patients with MS is the maximum prolongation of their socially meaningful life and activities. The successful implementation of rehabilitation activities is determined by assessing the patients rehabilitation potential. The integrative concept of rehabilitation potential includes the rehabilitation potential of the body, the rehabilitation potential of the individual (an active member of microsocial groups), and the rehabilitation potential of the personality. Achievement of rehabilitation aims is based on the emotional-volitional, intellectual, and motivational rehabilitation potential of the individual.
 AIM: This study aimed to demonstrate the importance of a systematic integrative approach toward all aspects of rehabilitation in MS, as well as the need to assess the rehabilitation potential in forming an individual rehabilitation program that determines the successful implementation of goals at various rehabilitation stages.
 MATERIALS AND METHODS: This article analyzes more than 500 certificates of examining patients with MS at the sociomedical expertise (SME) bureau to clarify the clinical and functional criteria leading to social maladjustment. Rehabilitation potential was assessed, and its significance was established in the form of an individual rehabilitation program. All aspects of the individual rehabilitation program for patients with MS (medical, social, and psychological) were analyzed in detail.
 RESULTS: The analysis of the examination certificates of patients with MS at the SME bureau and our clinical material (500 patients) revealed that during the initial examination at the SME bureau, groups with severe disability were most often identified (groups I and II amounted to 61%). An individual rehabilitation program was developed for the disabled with MS, considering all its aspects. The rehabilitation potential assessments in patients with MS, which is only the basis and prerequisite for the formation and implementation of an individual rehabilitation program, established that the rehabilitation potential has certain characteristics due to the variants of the disease course and prognosis, opportunities for such patients to work in social groups, and their psychological attitude toward life in illness situation. As a rule, the individual rehabilitation potential in patients with MS is quite high despite the disease severity and the guarded prognosis.
 CONCLUSION: A clear, coordinated system of medical, social, and professional measures of the rehabilitation process is required to achieve the maximum possible success in providing medical and social assistance to patients with MS.