Multiple sclerosis. Rehabilitation and long-term course

Multiple sclerosis (MS) is a highly complex disabling disease with variable pathology and clinical course. Progressive multisystemic involvement of the central nervous system leads to complex functional disturbances and disabilities. Despite disease-modifying therapies and pharmacological symptomatic treatment, the majority of MS patients develop progressive impairments in functions, activities and quality of life in the long-term. Rehabilitation interventions aim at improving symptoms and functional deficits and reducing the negative impact on activities and social participation. To evaluate the impact and value of rehabilitation interventions in MS. Specific literature search in PubMed. Good evidence exists for a positive effect of various rehabilitation interventions and multidisciplinary programs. Long-term prognosis is very variable and depends on various influencing factors. Due to an often unpredictable change of disease activity and the high variability, accurate prediction of long-term prognosis in individual MS cases is still challenging. Rehabilitation measures should be considered in an early phase of the disease for maintaining functional abilities and reducing the risk of progression of disabilities. Assignment to specific interventions and setting of rehabilitation depend on disease-specific and personal factors and specific goals. Monosyndromic or oligosyndromic impairments in the early phases of the disease can be approached by targeted monodisciplinary ambulatory interventions, whereas more severe and complex disabilities generally necessitate a more intensive multidisciplinary rehabilitation.