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Summary
In a chronic and disabling disease like multiple sclerosis, rehabilitation becomes
of major importance in the preservation of physical, psychological and social functioning.
Approximately 80% of patients have multiple sclerosis for more than 35 years and most
will develop disability at some point of their lives, emphasising the importance of
rehabilitation in order to maintain quality of life. An important aspect of multiple
sclerosis rehabilitation is the preservation of physical functioning. Hot topics in
the rehabilitation of physical function include (1) exercise therapy, (2) robot-assisted
training and (3) pharmacological interventions. Exercise therapy has for many years
been a controversial issue in multiple sclerosis rehabilitation and the advice generally
given to patients was not to participate in physical exercise, since it was thought
to lead to a worsening of symptoms or fatigue. However, a paradigm shift is taking
place and it is now increasingly acknowledged that exercise therapy is both safe and
beneficial. Robot-assisted training is also attracting attention in multiple sclerosis
rehabilitation. Several sophisticated commercial robots exist, but so far the number
of scientific studies that have evaluated these is limited, although some promising
results have been reported. Finally, recent studies have shown that certain pharmacological
interventions have the potential to improve functional capacity substantially, with
the potassium channel blocker fampridine being one of the most promising. This drug
has been shown to improve walking ability in some patients with multiple sclerosis,
associated with a reduction of patients' self-reported ambulatory disability. Rehabilitation
strategies involving these different approaches, or combinations of them, may be of
great use in improving everyday functioning and quality of life in patients with MS.
Keywords
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© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
