What use is rehab?

What components of rehabilitation are helpful from the perspective of individuals with multiple sclerosis? Salminen AL, Kanelisto KJ, Karhula ME. Disabil Rehabil. 2014. [Epub ahead of print]

Purpose: To investigate the helpful components of rehabilitation from the point of view of people with multiple sclerosis (MS). Methods: Sixteen focus groups were conducted for 68 adults with MS, who were 6 months through their 2-year multi-professional group-based out-patient rehabilitation programs in three regions of Finland. Data were analyzed using qualitative inductive content analysis combined with counts of the coded data. 

Results: Participants described 20 helpful components of rehabilitation that were clustered to themes of the rehabilitee himself/herself, structures of everyday life, information, activity, environmental interventions, social relationships and support. The most frequently described components of the seven main themes were peers, advice, physical exercise, assistive technology and home adaptations, and personal responsibility. 
Conclusions: The helpful components of both in-patient and out-patient rehabilitation that are of particular importance to people with MS are diverse and show the relevance of ICF in rehabilitation and the need for a comprehensive view in rehabilitation. The importance of peers and peer support should be taken into account in rehabilitation planning and related recommendations. The findings show that helpful rehabilitation for people with MS is not a set of mechanistic interventions but requires good social relationships and support. 
Implications for Rehabilitation: Helpful components of rehabilitation for people with MS are diverse and show the need for a comprehensive and individual view in rehabilitation. Professionally guided peer support should be offered as a part of rehabilitation. Interventions related to assistive technology and home adaptations should be an obvious part of rehabilitation. It is important to support people with MS to preserve identity as an active person and to take personal responsibility in their own rehabilitation.

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  • Yes, unless you take personal responsibility, you won't get anywhere. But to start rehab, there has to be hope – otherwise, why would you make the effort? That's why the attitude and 'bedside manner' (for want of a better word) of the neuro is SO crititical. I was lucky, I got Prof G. But how typical is his approach? Judging from some of the stories I read on shift.ms, many patients feel they've been written off. And that is the real scandal.

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