D-M. Suo et al.
694
102 patients referred
63 did not fit entry criteria
or refused to participate
39 randomised
21 assigned to
rehabilitation group
18 assigned to
control group
1 patient relapse
1 patient relapse
20 completed
4-week assessment
17 completed
4-week assessment
2 with missing
data at 3-months
3 with missing
data at 3-months
15 completed
3-months assessment
17 completed
3-months assessment
Fig. 1. CONSORT diagram for multimodal exercise training intervention.
differences between 2 groups were found at baseline
(Fig. 2).
Outcomes after rehabilitation
All patients completed high-dose intravenous methyl
prednisolone therapy (2–3 weeks from the acute at-
tack) and underwent an oral steroid tapering period to
achieve 10–15 mg/day.
Table II shows the median EDSS and FS scores for
the MDR and UC groups before treatment. No sta-
Table II. Extended Disability Status Scale (EDSS) and Functional
System scores to multidisciplinary rehabilitation (MDR) or usual
care (UC) before treatment
EDSS and EDSS subscales MDR n = 21
Median (range) Usual care n = 18
Median (range)
EDSS
Walking ability
Pyramidal function
Sensory function
Bowel and bladder
Cerebral function 7.5 (6.0–8.5)
7.5 (6–8.5)
4 (1–4)
3 (1–4)
2 (1–4)
2 (1–2) 7.5 (6.0–8.0)
7.5 (6.0–8.0)
4 (2–4)
3 (1–4)
2 (1–4)
2 (1–2)
Fig. 2. Extended Disability Status Scale (EDSS) and Functional System
(FS) scores for the multidisciplinary rehabilitation (MDR) (n = 21) or
usual care (UC) (n = 18) groups before and after 4 or 12 weeks of MDR
treatment. Numbers are statistically reported as the mean and standard
deviation (SD). ***p < 0.001; **p < 0.01; ***p < 0.05. FS-WA: walking
function. FS-PF: pyramidal functions. FS-SF: sensory functions. FS-BB:
bowel and bladder functions. FS-CF: cerebral (or mental) functions.
Table III. Changes in Extended Disability Status Scale (EDSS) and Functional System (FS) scores after treatment
EDSS subscales
MDR group (n = 17)
EDSS scores
Walking ability
Pyramidal function
Sensory function
Bowel and bladder
Cerebral function
UC group (n = 15)
EDSS total scores
Walking ability
Pyramidal function
Sensory function
Bowel and bladder
Cerebral function
a
Pre-MDR
Median (range) 4 weeks after MDR
Median (range) 3 months after MDR c
Median (range) p-value a p-value b p-value c
7.5 (6–8)
7.5 (6–8.5)
4 (1–4)
3 (1–4)
2 (1–4)
2 (1–2) 6.5 (5–7.5)
7.0 (5–8)
3 (1–4)
3 (1–4)
1.5 (0–3)
1 (1–2) 6 (2–7.5)
7.0 (2–8)
3 (1–4)
3 (1–4)
1 (0–2)
1 (0–2) < 0.001
0.003
< 0.001
0.083
0.001
0.083 < 0.001
0.002
< 0.001
0.083
< 0.001
0.002 0.083
0.066
0.002
0.317
0.059
0.002
7.5 (6–8.5)
7.5 (6–8.5)
4 (2–4)
3 (1–4)
2 (1–4)
2 (1–2) 7.5 (6–8)
7.5 (6–8)
3 (2–4)
3 (1–4)
2 (1–4)
1 (1–2) 7.5 (6–8)
7.5 (6–8)
3 (2–4)
3 (1–4)
2 (1–4)
1 (1–2) 0.083
0.083
0.083
0.083
0.059
0.317 0.023
0.023
0.014
0.083
0.059
0.157 0.499
0.157
0.083
0.317
0.317
0.317
Comparison between Pre-MDR and 4 weeks after MDR . b Comparison between Pre-MDR and 3 months after MDR. c Comparison between 4 weeks after
MDR and 3 months after MDR. MDR: multidisciplinary rehabilitation; UC: usual care. Significant values are shown in bold.
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