The multiple sclerosis functional composite correlates with the sociomedical recommendation of earning capacity of rehabilitants with Multiple Sclerosis

Abstract

The multiple sclerosis functional composite (MSFC) measures various MS- related impairments consisting of three subtests for mobility, motor hand function, and cognitive function. In medical rehabilitation, the MSFC may be a helpful instrument for the sociomedical recommendation of earning capacity (RoEC) at the end of rehabilitation. The aim of the study was to correlate the MSFC with the RoEC and to review the RoEC validity by the return to work (RTW) six months after discharge. In a retrospective unicenter longitudinal study, the MSFC of 84 rehabilitants of working age was determined at the beginning (t0) and end (t1) of inpatient rehabilitation. The MSFC (total score and subtests) was correlated with the RoEC (positive ≥ 3h per day; negative <3h per day). Six months after discharge, the RTW (positive ≥ 3h per day; negative <3h per day) was assessed. Seventy of the 84 rehabilitants (83 %) received a positive RoEC. They showed no differences in epidemiological, MS or rehabilitation-specific characteristics as compared to the 14 rehabilitants with negative RoEC. Rehabilitants with positive RoEC as compared to those with negative RoEC showed significantly higher scores in the MSFC total score (z-Score: +0.11 vs. -0.55, p < 0.001) and subtests cognition (PASAT-3: 42.3 points vs. 27.7 points; p < 0.001) and mobility (T24FW: 5.1 sec vs. 6.7 sec; p = 0.002). Whereas the motor hand function was without significant difference (NHPT: 23.4 sec vs. 26.5 sec; p = 0.064). Both groups changed for better in the total score and subtests over time (t0, t1), but without significance. The RTW after six months were determined in 31 of the 84 rehabilitants (37 %); 90 % of these rehabilitants judged their RoEC as applicable. A positive RoEC correlated significantly with a positive RTW (r = 0.411; p = 0.022). However, a correlation between MSFC (t1) (total score, subtests) and RTW after six months could not be observed. On function level, the MSFC (total score ≥ 0) correlates significantly with a positive RoEC at discharge whose validity was shown by correlation with the RTW six months after discharge. The subtests cognition and mobility were decisive. In medical rehabilitation of MS, determining the MSFC can be helpful for developing a valid recommendation for participation in the form of a RoEC.