Source: Transfusion  |  Posted 5 years ago

By Bruce Sylvester

MADRID, SPAIN -- October 1, 2006 -- Fatigue and functional deficits in multiple sclerosis (MS) patients were significantly improved during 4 weeks of inpatient rehabilitation, researchers reported here at the 22[^]nd[] Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS).

"Inpatient rehab works in MS patients, and we have seen in this study in detail that it works, especially ameliorating fatigue, function of upper limbs and cognition, " said lead investigator Stephan Bamborschke, MD, professor of neurology, Charit? Hospital, Berlin, and head of rehabilitation, Brandenburg Clinic, Bernau, Germany, who presented the findings on September 28[^]th[].

The purpose of the study was to assess the efficacy of neurological rehabilitation in MS patients, using the Multiple Sclerosis Functional Composite (MSFC, Cutter 1999) scale and measuring fatigue using the Fatigue Severity Scale (FSS, Krupp 1989), given to patients before and after rehabilitation.

"We also looked for parameters which possibly could predict the improvement of fatigue," the research team wrote in their poster presentation.

They enrolled 35 men and 103 women, age 22 to 61 years with a mean age of 44.1, who were in a stable phase of the disease.

Disease course among the subjects was primary progressive in 4%, relapsing remitting in 69% and secondary progressive in 24%.

(Expanded Disability Status Scale (EDSS) scores ranged from 1.0 to 7.0, with a mean of 4.1.

The variety of ongoing treatments included: interferon beta 1b (27%), subcutaneous interferon beta 1a (17%), intramuscular interferon beta 1a (11%), glatiramer-acetate (16%), azathioprine (4%) and mitoxanthrone (2%).

Researchers performed the FSS with 101 of the 138 patients, and the MSFC with 128 of the 138 patients. Both were done at the beginning and the end of rehabilitation.

Patients received a diagnosis of fatigue with FSS values higher than 23 (possible range 9-63).

All subjects also took the Beck Depression Inventory, and the Short Form 36 Health Survey Questionnaire (SF36) quality of life questionnaire at the beginning of rehabilitation.

During 4 weeks of neurological inpatient rehabilitation all patients underwent individually-modified treatment with physiotherapy, ergotherapy, aerobic physical exercise, and, when appropriate individually, neuropsychological training.

The investigators reported that mean FSS score was 45.0 +/- 1.5 at the beginning of rehabilitation and 42.2 +/- 1.6 at the end. Mean MSFC score was -0.38 +/- 0.07 at the beginning of rehabilitation and -0.24 +/- 0.09 at the end.

They observed significant improvement of fatigue ([]P[] = .002) and MSFC score ([]P[] = .000035).

"The improvement of fatigue could not be predicted by gender, age, EDSS, initial MSFC values, quality of life measurement or extent of depression," they noted.

[Presentation title: Efficacy of Neurological Inpatient Rehabilitation Measured By Fatigue Severity Scale and Multiple Sclerosis Functional Composite in Multiple Sclerosis Patients. Abstract P431]