Effects of multidisciplinary inpatient rehabilitation on everyday life physical activity and gait in patients with multiple sclerosis.
Gaëlle Prigent, Kamiar Aminian, Roman Rudolf Gonzenbach and 2 others
PMID 38807215WHAT IT FOUND
Multidisciplinary inpatient rehabilitation improved walking capacity and self-reported mobility in people with multiple sclerosis, but these gains did not translate into faster or longer walking at home.
Mildly disabled patients walked slightly more, while severely disabled patients showed no change in daily activity.
Key findings
01Supervised walking tests showed significant improvement after rehabilitation, with clinically meaningful gains in the 2-minute walk test for both mildly and severely disabled patients.
02Daily life monitoring revealed no significant improvement in free-living gait speed or cadence for either disability group, despite the gains seen in clinical tests.
03Mildly disabled patients increased their percentage of time spent walking and the complexity of their daily activity patterns, but severely disabled patients did not change their daily physical activity behavior.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was not randomized and lacked a control group, so changes cannot be definitively attributed to the specific components of the rehabilitation program versus natural variation or placebo effects. Home monitoring relied on patients correctly attaching sensors themselves, which introduces potential measurement error, although algorithms were designed to be robust. The sample size was insufficient to stratify patients into more granular disability subgroups (e.g., distinguishing low from moderate disability). Key confounding factors such as employment status, season, weather, and motivation were not controlled for in the analysis.
Declared interests
The study was funded by Austrian government ministries and the federal state of Salzburg under the COMET research programme.
The easy way to misread this
Do not assume that significant improvements in supervised walking tests, such as the 10-meter or 2-minute walk, reflect an immediate improvement in the patient's ability to walk faster or longer in their daily life. The study found that while capacity improved, free-living gait speed and activity levels remained largely unchanged, especially for those with severe disability.