Rehabilitation in progressive multiple sclerosis

Abstract

Probably half of the multiple sclerosis (MS) patients worldwide have progressive MS (PMS) and seek therapy beyond prevention of inflammatory bouts. Therapy plans in PMS have to focus on improvement of abilities in individual problem constellations. Standardized assessment methods in MS beyond the expanded disability status scale (EDSS) have been developed. Recent studies show positive effects for activating therapies in immobile MS patients. Fair evidence exists for several nonpharmacological therapies. Some data indicate activation of neurotrophic factors and neuroplasticity during therapy. Few medication strategies including corticoid pulses are at hand for PMS. Combined pharmacological and multimodal symptomatic approaches promise increased efficacy. Complex inpatient therapy schemes may be of special value for severely affected patients.