Outcomes of inpatient rehabilitation of patients with multiple sclerosis

Background: Several trials have demonstrated improved outcomes following inpatient rehabilitation for Multiple Sclerosis patients. Two populations were studied: patients in relapse and patients with no active medical problems recruited from the community. In every day practice, most admissions for MS inpatient rehabilitation aim to improve function following sudden deterioration. The outcomes of inpatient rehabilitation for this population were never studied. Method: Retrospective case note analysis of consecutive admissions of MS patients from 2005 to 2009 to a specialist neurological rehabilitation unit. Results: Forty-one cases were identified. 26 were females. Age 25-71 (mean 52 +/- 12). Disease duration 0-39 years (mean 13 +/- 11). 20 patients were admitted from the community and 21 were transferred from acute hospital beds. Length of stay ranged between 11 to 152 days (mean 49 +/- 36). Mean length of stay for wheelchair dependent patients was approximately double the length of stay for ambulatory patients. Improving mobility, transfer or posture were the primary cause of admissions in 37 cases. Sixteen out of 21 ambulatory patients (76%) attained 100% mobility goals. Only 4 out of 20 wheelchair bound patients (20%) achieved 100% mobility goals (P 0.002). Neither the type of MS nor the duration of it influenced the overall outcome. Conclusion: Our results suggest that MS patients admitted for rehabilitation following deterioration secondary to a medical or surgical cause show the same favourable outcome that was demonstrated with MS stable patients or in relapse. Baseline mobility, but not type and duration of MS, seems to have a significant impact on the rehabilitation outcome in terms of gaol achievement.