[Rehabilitation therapy in multiple sclerosis].
OBJECTIVE
To review the rehabilitation therapy and rating scales used in multiple sclerosis (MS), as well as the clinical studies conducted to evaluate the effectiveness of rehabilitation therapy and the most common symptoms.


METHODS
MS has a number of very specific features that will have to be taken into account when undertaking rehabilitation therapy. It is a disease that progresses in a fluctuating and unpredictable manner and, to date, there is no treatment to cure it. There is a possibility of spontaneous recovery, especially in the early stages of the disease. Evaluation of the effectiveness of rehabilitation in MS must be performed on different levels that take into account both particular aspects of rehabilitation and an overall assessment of the treatment being provided. Most studies report improvements in disability and quality of life, while deficit remains unchanged. Any improvements that are achieved tend to decline over time, which makes it necessary to perform a follow-up after rehabilitation therapy ends. Certain symptoms such as fatigue, spasticity, ataxia and sphincteric disorders will benefit from suitable pharmacological treatment applied together with the rehabilitation therapy.


CONCLUSIONS
The value of rehabilitation therapy for MS patients lies in its ability to improve disability and the quality of life; since its effects decline over time, regular check-ups will be essential. Proving the effectiveness of rehabilitation in a heterogeneous pathology that develops progressively, such as MS, is a complex matter and further research with better designs and rating scales needs to be conducted.
Terré-Boliart
R
R
Unidad de Daño Cerebral, Institut Guttmann, Hospital de Neurorehabilitació, Badalona, Barcelona, España. metges@guttmann.com
Orient-López
F
F
D001259:Ataxia / Q000628:therapy; D018450:Disease Progression; D005221:Fatigue / Q000628:therapy; D006801:Humans; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy*; D009128:Muscle Spasticity / Q000628:therapy; D011788:Quality of Life; D016896:Treatment Outcome