Background: There is insufficient evidence to support the effectiveness of multidisciplinary rehabilitation on the health-related quality of life (HRQoL) of MS patients.
Objectives: To evaluate the longer term effectiveness of inpatient multidisciplinary rehabilitation on the HRQoL of MS patients.
Methods: The study was a two-hospital, pragmatic, randomized controlled trial with a 6-month follow-up. Patients aged 18-65 years with MS and Expanded Disability Status Scale scores ≤7.5 were randomly assigned (1:1) to 4 weeks of inpatient multidisciplinary rehabilitation (20 days of scheduled rehabilitation) or 6 months on a wait list. The outcome measures were Functional Assessment in Multiple Sclerosis (FAMS), Multiple Sclerosis Impact Scale-29 (MSIS-29), EQ-5D-5L and 15D.
Results: We randomized 213 patients to the wait-list control group and 214 patients to the treatment group. Trends in favour of the treatment group were observed across all measures. However, the difference was significant in only two of the six measures. The treatment effect was -2.7 (95% CI: -5.6 to (-0.1)), p = 0.046) for the MSIS-29 Psychological and 0.017 (95% CI: 0.005-0.030, p = 0.008) for the 15D. FAMS, which we used to calculate the sample size, was not significant.
Conclusion: The results indicated that inpatient multidisciplinary rehabilitation is effective in improving the HRQoL of MS patients after 6 months.
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http://dx.doi.org/10.1177/1352458517735188 | DOI Listing |
Curr Pain Headache Rep
January 2025
Department of Pain Medicine, Division of Anesthesiology, Critical Care & Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Purpose Of Review: Quickly referenceable, streamlined, algorithmic approaches for advanced pain management are lacking for patients, trainees, non-pain specialists, and interventional specialists. This manuscript aims to address this gap by proposing a comprehensive, evidence-based algorithm for managing neuropathic, nociceptive, and cancer-associated pain. Such an algorithm is crucial for pain medicine education, offering a structured approach for patient care refractory to conservative management.
View Article and Find Full Text PDFPhys Ther Res
November 2024
Department of Neurosurgery, Tsuchiura Kyodo General Hospital, Japan.
Objective: To investigate the impact of multidisciplinary team (MDT) intervention for early mobilization (EM) of patients with aneurysmal subarachnoid hemorrhage (aSAH) in the intensive care unit (ICU).
Methods: A retrospective uncontrolled before-after observational study was conducted to assess patient outcomes before and after introducing MDT in the stroke care unit (SCU). Participants admitted to the SCU from April 2017 to September 2023 were categorized into conventional (April 2017 to June 2020) and MDT (July 2020 to September 2023) groups.
BMC Oral Health
January 2025
School of Dentistry, Catholic University of Pelotas (UCPel), Campus da Saúde, Av. Fernando Osório, 1586-Pelotas, Pelotas, RS, Brazil.
Background: Dengue virus (DENV) infection, a mosquito-borne disease, presents a significant public health challenge globally, with diverse clinical manifestations. Although oral dengue manifestations are uncommon, they can serve as crucial diagnostic indicators and impact patient management in dental practice. This scoping review aims to map the evidence on the oral manifestations associated with DENV infection and their clinical implications for dental practice.
View Article and Find Full Text PDFMult Scler Relat Disord
January 2025
Department of Clinical Neurological Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Context: Persons with advanced multiple sclerosis (MS) require care beyond the disease modifying treatments offered in conventional MS clinics to address their complex physical and psychosocial needs. In the novel MS Comprehensive and Palliative Care (MSCPC) Program, an MS neurologist, palliative care specialist, and physiatrist collaborate to identify these needs and improve symptom control.
Objectives: To characterize the medical, physical, and psychosocial concerns of persons with advanced disability from MS and describe the recommended interventions of the MSCPC Program.
Lancet Neurol
February 2025
Department of Neurology AB51, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
The age-specific incidence of traumatic brain injury in older adults is rising in high-income countries, mainly due to an increase in the incidence of falls. The severity of traumatic brain injury in older adults can be underestimated because of a delay in the development of mass effect and symptoms of intracranial haemorrhage. Management and rehabilitation in older adults must consider comorbidities and frailty, the treatment of pre-existing disorders, the reduced potential for recovery, the likelihood of cognitive decline, and the avoidance of future falls.
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