Rehabilitation for Multiple Sclerosis in Adults (I); Impairment and Impact on Functioning and Quality of Life: An Overview

Multiple sclerosis (MS) is a chronic, central nervous system, disabling disease. International Classification of Functioning and relevant generic and specific outcome measures are reported. Problems perceived by people with MS (PwMS) affect mobility, sight, continence, feeding, or cognitive impairment, depending on whether acute, chronic, or long-term disability was involved. The most common body function and structure impairments leading to disability and reported by health care professionals are fatigue, weakness, decreased fitness, sensory disorders, pain, upper motor neuron syndromes, ataxia and tremor, balance and postural control problems, gait pattern disorders, visual problems, and neurogenic lower urinary tract and bowel dysfunction; sexual, autonomic, neuropsychological, and neuropsychiatric impairment; dysarthrophonia, dysphagia, and respiratory and sleep disorders. The most frequently affected activities and relationships include mobility, domestic life, community and social activities, remunerative employment, interpersonal relationships, self-care, learning and applying knowledge, and economic life. Limitations in activities of daily life because of fatigue, pain, visual problems, incontinence, sexual and cognitive impairment, depressive disorders, sleep disorders, economic pressure, employment status, and lack of information have an impact on quality of life (QoL). Increased caregiving tasks, psychological burden, limitation in activities and participation, and reduced QoL have a profound influence on caregivers. This paper summarizes the perception of problems and needs, the disease's impact on functioning and QoL of PwMS, and the impact on their significant others and caregivers, according to health and social research.Martinez-Assucena, A.; Marnetoft, S.; Roig Rovira, T.; Hernandez-San-Miguel, J.; Bernabeu, M.; Martinell-Gispert-Sauch, M. (2010). Rehabilitation for Multiple Sclerosis in Adults (I); Impairment and Impact on Functioning and Quality of Life: An Overview. Critical Reviews in Physical and Rehabilitation Medicine. 22(1-4):103-178. doi:10.1615/CritRevPhysRehabilMed.v22.i1-4.90103178221-

Rehabilitation for Multiple Sclerosis, in Adults (II); Management and Impact on Impairment, Functioning, and Quality of Life: An Overview

Multiple sclerosis (MS) often leads to different levels of severity and progression of impairment and disability and to dissimilar levels of limitation in activities and participation in different social domains, with varying impacts on quality of life (QoL) among people with MS (PwMS). Results have shown that, for PwMS, prioritizing goal setting may enhance adherence to treatment. Interdisciplinary rehabilitation may prolong the functional status level of PwMS, may result in transient improvement in the aspects of impairment features, may increase their participation in activities, and may improve their QoL, even when disease progression is not modified. Single rehabilitation packages of comprehensive care have proven beneficial, such as physiotherapy, which enhances aerobic capacity, strength, pain, mood, mobility, and QoL. Occupational therapy can help reduce the impact of impairment on QoL, especially fatigue. Neuropsychological interventions, such as learning and memory remediation, psychological intervention for depressive disorders, and acquistion of coping skills and self-management techniques help PwMS to adjust to disease and disability. Speech therapy can improve intelligibility of communication. Learning swallowing techniques can help prevent material from entering the airway. Clean intermittent self-catheterization can help prevent urinary tract infections. Power wheelchairs enhance occupational performance and energy conservation. Further vocational rehabilitation settings and research are required for more appropriate interventions due to high unemployment rates among PwMS. Comprehensive care for PwMS should include planning for future independent living and long-term care needs.Martinez-Assucena, A.; Marnetoft, S.; Roig Rovira, T.; Hernandez-San-Miguel, J.; Bernabeu, M.; Martinell-Gispert-Sauch, M. (2010). Rehabilitation for Multiple Sclerosis, in Adults (II); Management and Impact on Impairment, Functioning, and Quality of Life: An Overview. 22(1-4):179-239. doi:10.1615/CritRevPhysRehabilMed.v22.i1-4.100179239221-