Международный журнал физической медицины и реабилитации
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Effects of an Inpatient Multidisciplinary Intervention on Physical Ability and Self Perceived Health Status in Multiple Sclerosis and Parkinson

Bjørnar Berli, Randi Dalen, Bente Oldren and Torbjorn Rundmo

Objective: The current study’s objectives were to investigate the effects of a multidisciplinary intervention (MDI) for multiple sclerosis (MS) and Parkinson's disease (PD) patients on physical ability and self-perceived health status, and to examine the relationship between physical ability and health status in these patient groups.

Methods: 110 patients (44 with PD, 66 with MS) were enrolled in a 4-week inpatient MDI program. Measures of health status (SF-12) and physical ability (6 min walking, timed up-and-go test, and sit-to-stand test) were administered before and after intervention.

Results: The results showed significant improvements on physical performance and increased physical and mental health status in both patient groups. Physical health status (PCS) correlated significantly with all three physical tests. Physical test scores showed a significant predictive value on PCS. Few previous studies have explored the effects of short, intensive, inpatient treatment programs on quality of life measures in these patient groups. Results of the current study suggest that the short intensive inpatient rehabilitation is effective in producing short term improvements.

Conclusion: The conclusion is multiple sclerosis and Parkinson’s disease patients seem to benefit from a multidisciplinary intervention, improving both objective and subjective perceptions of health. As expected, physical ability was closely related to perceived physical health, but not mental health, highlighting the importance of addressing psychological symptoms separately in treatment. Knowing the heterogeneity of among the two groups of patients regarding symptoms and disability, finding an ‘ideal’ intervention across patients is nearly impossible. This variation within the patient groups makes studying mechanisms of change, or pathways leading to improvements in quality of life, difficult. Two plausible mechanisms are proposed: First, improvements on the level of physical function may influence health status positively. Secondly, the holistic, multidisciplinary approach to treatment may target nonmotor factors important to patient-perceived health status. The results of the current study also supported a holistic multidisciplinary approach to treatments for Parkinson’s disease and multiple sclerosis patients.