| Table 4-3 Summary of Outcome Studies of Comprehensive Rehabilitation in People with MS |
| Study | Study Design | Sample (n) | Main Outcomes/ Instruments | Time of Assess- ments | Results |
| Inpatient Rehabilitation |
| Fergenson et al. | Prospective, single group, pre- and poststudy design | 20 | Impairment, dusability and handicap: MS funtional profile (a modified versionh of BUSTOP)
Costs of intervention | Admission and discharge costs were also measured at 12 Months (by telephone interview) | Significant benefit in disability and handicap, no change in impairment |
| Greenspanb et al. | Retrospective, single group, pre- and poststudy design | 28 | Disability: CRDS | Admission, discharge, and 30-month review (by telephone if necessary) | Benefits across a range of disabilities, which were maintained at 3 months |
| Reding et al. | Retrospective study, using case-matched analysis | 20 pairs | Disability: ISS Hostpital readmission rate
Cost of intervention. THe need for home assistance | Review at 16 months (by Telephone) | No difference between groups |
| Carey et al. | Retrospective multicebter study assessing a range of condition. Single group, pre- and poststudy design | 6194, of whom 196 had MS | Disability: LORS-II | Admission and discharge | Improvements in ADL and mobility |
| Francabandera et al. | Prospective, stratified, randomized study | 84 | Disability: ISS Need for home assistance (hours) | Admission and at 3-month intervals for 2 years (3-month results reported in this poublication) | Preliminary results suggest marginal benefit in inpatient group |
| Kidd et al. | Prospective, single group, pre- and poststudy design | 79 | Impairment: DSS
Disabilty: Barthel Index
Handicap: ESS | Admission and discharge | Statistically significant improvement in disabvility and handicap |
| Freeman et al. | Prospective, single group, longitudinal study design | 50 (all in the prog. stage) | Impairment: FS and EDSS
Disability: FIM
Handicap: LHS
Quality of life: SF-35
Emotional well-being: GHQ-28 | Admission and discharge and at 3-month intervals for 1 year | Benefits in disability, handicap, Quality of Life, and emotional well being persist for 6-9 months |
| Solari et al. | Randomized single group stuidy comapring inpatient and home exercise program | 30 (ambula- tory) | Impairmet: EDSS
Disability: FIM
Quality of LIfe: SF-36 | Baseline, 3, 9, and 15 weeks | Benefits in disability and some aspects of Quality of Life |
| Aisen et al. | Retrospective, single group, pre- and poststudy design | 37 | Impairmet: FS and EDSS
Disability: FIM | Admission, discharge, and telephone follow-up (between 6 and 36 months post discharge) | Significant improvement in both FIM and EDSS |
| Kidd, Thompson | Prospective, single group, pre- and poststudy design | 47 | Impairment: FS and EDSS
Disability: FIM | Admission, discharge, and 3-month follow-up | Gains in disability maintained at 3 months handicap improved over study period |
| Freeman et al. | Stratified, randomized, wait list controlled study design | 66 (all in the prog. stage) | Impairment: FS and EDSS
Disability: FIM
Handicap: LHS | Baseline and 6 weeks | Significant benefit in disability and handicap |
| Outpatient Rehabilitaion |
| Di Fabio et al. | Nonequivalent pre-test, post-test control group design | 45 with prog MS | MS-related symptom RIC-FAS Fatique frequency | All entry at one year | 33 patients completed one year
Significant benefit seen in SM related symptoms, including fatigue |
| BUSTOP: Burke Stroke Time-oriented Profile; CRDS: Computerized Rehabilitation and Data System; DSS: Disability Status Scale; EDSS: Expanded Disability Status Scale; ESS: Environmental Status Scale; FIM: Functional Independence Measure; LORS-II: Revised Level of Rehabilitation Scale; FS, Functional Systems; ISS: Incapacity Status Scale; LHS: London Handicap Scale; SF-36: Short Form 36 Health Survey Questionnaire; GHQ-28: 28-item General Health Questionnaire; RIC-FAS: Rehabilitation Institute of Chicago, Functional Assessment Scale. |
