Development and validation of a practical documentation of inpatient rehabilitation goals, therapy content and outcomes for improving mobility in people with multiple sclerosis in Austria: A multicentre single-arm pragmatic clinical trial

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2026-05-01 Epub Date: 2026-02-26 DOI:10.1016/j.msard.2026.107100

Andreas Wanitschek , Barbara Seebacher , Barbara Linert , Andreas Mühlbacher , Robert Hatschenberger , Nicole Kranawetter , Lisa Tischler , Monika Scarpatetti , Verena Walder , Alexandra Holzinger , Bernhard Haider , Doris Hörtenhuber , Eva Kronberger-Schaffer , Viktoria Mangold , Christian Brenneis , Rainer Ehling

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引用次数: 0

Abstract

Background

Improved understanding of effective therapeutic interventions (TI) is required to optimise mobility outcomes in people with multiple sclerosis (pwMS) undergoing multidisciplinary neurological rehabilitation (MNR). The primary objective was to explore clinically meaningful effects of active TI on mobility during inpatient MNR. Secondary objectives were to assess mobility-related goal attainment and to develop and evaluate a standardised TI documentation catalogue.

Methods

A TI catalogue and manual were developed and refined based on moderate interrater reliability from 12 video-recorded therapy sessions rated by eight clinicians. Usability was assessed by 47 physiotherapists using the System Usability Scale (SUS). Mobility outcomes included the 12-item Multiple Sclerosis Walking Scale (MSWS-12), 2-Minute Walk Test (2 MWT), Five Times Sit-to-Stand Test (5-TSTS), and Timed 25-Foot Walk. Effect sizes were calculated for individual and group-based TI. Goal attainment was measured using Goal Attainment Scaling.

Results

The TI catalogue showed good usability (mean SUS score 72.3). Significant improvements were observed across all mobility outcomes, with clinically meaningful changes for MSWS-12, 2MWT and 5-TSTS. Gait training variants, robot-assisted gait training, strength, task-oriented, dual-task, endurance, coordination, and balance training showed medium-to-large effect sizes. Goal achievers demonstrated significantly greater improvements in walking perception, speed, and distance than non-achievers, with no difference in sit-to-stand performance. Over 88% of 255 pwMS achieved or exceeded their therapy goals.

Conclusions

The TI catalogue is a reliable and practical tool for documenting TI in routine MNR. Several interventions, particularly stair gait training, strength training, and robot-assisted gait training, were associated with clinically meaningful mobility improvements in pwMS.

Trial registration

The study was prospectively registered with the German Clinical Trials Register (DRKS00025216 and DRKS00030391).

查看原文本刊更多论文

奥地利多发性硬化症患者住院康复目标、治疗内容和改善活动能力结果的实用文献的开发和验证：一项多中心单臂实用临床试验。

背景：需要提高对有效治疗干预（TI）的理解，以优化接受多学科神经康复（MNR）的多发性硬化症（pwMS）患者的活动结果。本研究的主要目的是探讨活动性TI对住院患者MNR期间活动能力的临床意义。次要目标是评估与移动性相关的目标实现情况，并制定和评估标准化的TI文件目录。方法：根据8位临床医生评定的12个治疗视频记录，制定并完善TI目录和手册。可用性由47名物理治疗师使用系统可用性量表（SUS）进行评估。活动能力指标包括12项多发性硬化症步行量表（MSWS-12）、2分钟步行测试（2 MWT）、5次坐立测试（5-TSTS）和定时25英尺步行。计算了个体和群体TI的效应量。使用目标实现量表测量目标实现情况。结果：TI目录具有较好的可用性（SUS平均分72.3分）。所有活动能力指标均有显著改善，其中MSWS-12、2MWT和5-TSTS的变化具有临床意义。步态训练变体、机器人辅助步态训练、力量训练、任务导向训练、双任务训练、耐力训练、协调训练和平衡训练显示出中等到较大的效应量。目标完成者在步行感知、速度和距离方面的进步明显大于非目标完成者，而坐立表现没有差异。超过88%的255名pwMS达到或超过了他们的治疗目标。结论：TI目录是常规MNR中记录TI的可靠实用工具。一些干预措施，特别是楼梯步态训练、力量训练和机器人辅助步态训练，与临床上有意义的pwMS患者的活动能力改善有关。试验注册：该研究已在德国临床试验注册中心（DRKS00025216和DRKS00030391）前瞻性注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.