title: [Multimodal complex treatment in multiple sclerosis : influence on motor performance and need of care].
abstract: BACKGROUND
  The concept of multimodal complex treatment combines treatment by physicians with intensive conservative treatment. The therapy duration is often 14-21 days. Investigations showing the benefit of this treatment for multiple sclerosis patients are currently missing.
  
  
  METHODS
  A total of 220 patient records were retrospectively analyzed with respect to the Barthel index, the expanded disability status scale (EDSS) score and early rehabilitation assessment (Frühreha-Assessment). Subgroup analysis was used to examine variations in clinical severity, age and disease duration.
  
  
  RESULTS
  The motor subscore was improved (p = 0.031) in the total sample. The subgroup analysis showed that in particular patients with an average disease duration (11-20 years) and age (41-60 years) showed the greatest benefits. In addition to the group of moderately affected patients the group of severely affected patients (Barthel index 36-64 and < 35) also showed an improvement in the Barthel index.
  
  
  CONCLUSIONS
  Multimodal complex treatment for MS patients can lead to a significant improvement in motor abilities and reduction of the need of nursing. In particular intermediately affected patients showed the strongest improvement in contrast to the results of the current appraisal of the German Medical Review Board of the Health Insurance Funds (MDK).
authors.affiliation: Fachklinik für Neurologie Dietenbronn, Akademisches Krankenhaus der Universität Ulm, Dietenbronn 7, 88477, Schwendi, Deutschland. d.ecker@fachklinik-dietenbronn.de
authors.forename: D
authors.initials: D
authors.lastname: Ecker
authors.forename: E
authors.initials: E
authors.lastname: Mauch
authors.forename: M
authors.initials: M
authors.lastname: Sabolek
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D004185:Disability Evaluation; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000534:rehabilitation*; D009460:Neurologic Examination; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D012189:Retrospective Studies