EXTENDED OUTPATIENT REHABILITATION - ITS INFLUENCE ON SYMPTOM FREQUENCY, FATIGUE, AND FUNCTIONAL STATUS FOR PERSONS WITH PROGRESSIVE MULTIPLE-SCLEROSIS
Rp. Difabio et al., EXTENDED OUTPATIENT REHABILITATION - ITS INFLUENCE ON SYMPTOM FREQUENCY, FATIGUE, AND FUNCTIONAL STATUS FOR PERSONS WITH PROGRESSIVE MULTIPLE-SCLEROSIS, Archives of physical medicine and rehabilitation, 79(2), 1998, pp. 141-146
Objective: To determine the influence of an extended outpatient rehabi
litation program on symptom frequency, fatigue, and functional status
for persons with multiple sclerosis (MS). Design: Nonequivalent pretes
t/posttest control-group design, with posttest 1 year after initial as
sessment. Multiple regression analysis and analysis of covariance were
used to control for symptom severity at the initial assessment and co
morbid factors including depression, cognitive function, and social in
teraction. Effect sizes (ES) provided a descriptive measure of the cha
nge in outcomes. Setting: Outpatient multidisciplinary rehabilitation
clinic. Patients: Forty-six patients with definite chronic progressive
MS; 20 received treatment and 26 were in a nontreatment comparison gr
oup (''waiting list''). Intervention: Rehabilitation services for 5 ho
urs, 1 day per week, over 1 year. Main Outcome Measures: The MS-Relate
d Symptom Checklist composite score, fatigue frequency, and selected i
tems from the Rehabilitation Institute of Chicago Functional Assessmen
t Scale. Results: Receiving treatment was a significant predictor of r
educed symptom frequency (partial r(2) = .26) at the 1-year follow-up.
The ES adjusted for baseline values indicated substantial reductions
in symptom frequency for the treatment group (EStreatment = .27 vs ESw
aitlist = -.32). Fatigue aias significantly reduced at the time of fol
low-up for the treatment group compared with the waiting list group (E
Streatment = .46 vs ESwaitlist = -.20). There were no statistically si
gnificant differences among groups regarding functional status, but th
ere appeared to be less loss of functional status in the treatment gro
up compared with the waiting list group (EStreatment = -.07 vs ESwaitl
ist = -.70). Conclusions: An extended outpatient rehabilitation progra
m for persons with definite progressive MS appears to effectively redu
ce fatigue and the severity of other symptoms associated with MS. (C)
1998 by the American Congress of Rehabilitation Medicine and the Ameri
can Academy of Physical Medicine and Rehabilitation.