Abstract
There is a strong body of evidence that supports the use of non-drug therapies in the management of people with multiple sclerosis (MS). A 5-day residential retreat for people with MS in Victoria, Australia, promotes lifestyle modification within a patient-centred model of care. Analysis of the health-related quality of life (HRQOL) of the retreat participants was undertaken using the MSQOL-54, prior to attendance, 1 and 5 years after the retreat. 274 retreat participants (71%) completed baseline questionnaires. Despite the usually progressive nature of MS, the cohort demonstrated clinically and statistically significant improvements in HRQOL. One year after attending the retreat, median improvements of 11.3% were observed in the overall quality of life domain (p < 0.001); 18.6% in the physical health composite (p < 0.001); and 11.8% in the mental health composite (p < 0.001). In the subset of 165 who had reached the 5-year time-point, there was a 19.5% median improvement in overall quality of life (p < 0.001); 17.8% in the physical health composite (p < 0.001) and 22.8% in the mental health composite (p < 0.001), compared to baseline. Attendance at a retreat promoting lifestyle modification for the integrated management of MS appears to have positive effects on short and medium-term HRQOL. Non-drug therapies should be considered as part of any comprehensive treatment plan for people with MS.
Highlights
Multiple sclerosis (MS) is the most common progressive neurological disorder affecting young adults [1]
One year after attending the retreat, median improvements of 11.3% were observed in the overall quality of life domain (p \ 0.001); 18.6% in the physical health composite (p \ 0.001); and 11.8% in the mental health composite (p \ 0.001)
Lifestyle modification should form part of any comprehensive chronic disease management plan, and given that there are likely to be other health benefits associated with this approach, there is considerable merit in offering this to people with multiple sclerosis (MS)
Summary
Multiple sclerosis (MS) is the most common progressive neurological disorder affecting young adults [1]. Women are twice as likely as men to be affected with MS, with an estimated incidence rate of 3.6 per 100,000 [2], varying considerably with geographic region. MS is thought to be immune-mediated, despite decades of research, the aetiology and factors that trigger relapses and influence disease progression continue to be debated [3]. Disease activity and clinical course are unpredictable, usually resulting in a broad range of symptoms and functional limitations, with depression and fatigue the most common [4]. Many patients report feelings of hopelessness and uncertainty, if they are not actively engaged in decision-making about their care [5]. MS can have a major impact on families due to increased role responsibilities, social isolation, employment challenges and financial hardship
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