[Rehabilitation management in neurologic follow-up of the multiple sclerosis patient]

Abstract

New immunomodulatory treatments of Multiple Sclerosis lead to considerable changes in the doctor-patient relationship. Today the neurologist must become involved in comprehensive management of MS patients. He/She must become familiar with the specific methodology of assessment in rehabilitation, and especially with the measurement of disability. Some specific measures have been developed in this field, i.g. the Functional Independence Measure (FIM). Although no significant change was demonstrable on neurological status decline as measured by EDSS in progressive phase, several recent controlled studies have demonstrated the efficacy of inpatient or outpatient rehabilitation programs, when assessment was based on disability, handicap and quality of life measurement. We emphasized the neurologist's role in determining adequate timing for rehabilitation according to the course of disease and therapeutic choices, but also in the setting of patient-centered functional goals for rehabilitation program.