Neurorehabilitation in multiple sclerosis

Introduction. Multiple sclerosis (MS) is the second most important/common cause of neurological disability in young adults. Current treatment includes the new immunomodulating agents and various drugs used in symptomatic management. Neurorehabilitation (NR) complements these treatment forms an integral therapeutic strategy and is orientated to improve the activity and participation of the patient from a biopsychosocial point of view. Development. Although there is a generally favorable opinion towards NR, there is little scientifically validated evidence regarding the benefits of its use. Correct measurement of the results is essential for their interpretation in terms of efficiency and efficacy. Of the various instruments for measurement of the results of NR, there ave scales which have been shown to be of satisfactory clinical usefulness and scientifically sound for use in NR programmes in MS. In spite of methodological difficulties for the design of protocols in this field, in recent years several well-designed studies (randomised, controlled double or single blind) have shown the usefulness of NT in MS (both outpatients and inpatients and including progressive forms) since handicap has been reduced and quality of life improved. These studies refer to NR as a multidisciplinary approach (a specially trained team of professionals) with concrete objectives and established job descriptions a suitable battery of instruments for measurement of the results, active participation of the patient and his family and correct follow-up in the community.