People with multiple sclerosis who can walk at a relatively normal speed and effectively process information are more likely to continue to participate in social activities, according to a new study by researchers at Karolinska Institutet in Sweden published in the Multiple Sclerosis Journal. The findings highlight the importance of integrating motor and cognitive rehabilitation in the care of patients with MS.
MS is a chronic neurological disease often diagnosed at a young age. Symptoms vary and can include fatigue, pain, cognitive disturbances, muscle weakness and difficulty in maintaining balance. Over time many people with MS experience restrictions in participation in societal life, and work, relationships and leisure activities can be affected.
In this study, the researchers aimed to identify which factors are important for people with MS to maintain their participation in more complex activities in everyday life. The findings can help identify which rehabilitation efforts are more likely to support societal participation and enhance quality of life for those affected by MS. The study followed 264 people with MS over a period of 10 years and analyzed how participation in social activities changed over time in this group. Studied factors included age, gender, living situation, educational level, work capacity, disease course, disease modifying pharmacological treatment, walking ability, cognition and depressive symptoms.
The results showed that a majority, 67 percent, of those with mild MS continued to participate in daily social activities after 10 years, while only 26 percent of those with moderate MS and 5 percent of those with severe MS maintained their societal activity level. Factors that mattered more than others for continued participation were capacity to walk with a speed of at least 1.2 meters per second and having the cognitive ability to quickly process information in a clinical test. Factors deemed less significant included gender, living situation, work status and disease modifying pharmacological treatment.
Need for integrated rehabilitation
“Our study shows that factors such as walking speed and cognitive function are of particular importance for people with MS to continue their participation in complex societal activities, which in turn are of importance for maintaining health and quality of life in this group,” says David Conradsson, assistant professor at the Department of Neurobiology, Care science and Society (NVS), who together with Associate Professor Sverker Johansson at NVS where the study’s main authors. “There is a great need to develop motor and cognitive rehabilitation for people with MS throughout the course of the disease, preferably through an integrated rehabilitative approach where body and thought are considered together rather than as two separate phenomena.”
The study was funded by the Strategic Research Area Health Care Science at Karolinska Institutet.
“Participation in social/lifestyle activities in people with multiple sclerosis: Changes across 10 years and predictors of sustained participation,” Sverker Johansson, Charlotte Ytterberg, Kristina Gottberg, Lotta Widén Holmqvist, Lena von Koch and David Conradsson, Multiple Sclerosis Journal, October 17, 2019, DOI: 10.1177/1352458519881991