EXTENDED OUTPATIENT REHABILITATION - ITS INFLUENCE ON SYMPTOM FREQUENCY, FATIGUE, AND FUNCTIONAL STATUS FOR PERSONS WITH PROGRESSIVE MULTIPLE-SCLEROSIS

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.