Actividad acuática adaptada en el tratamiento rehabilitador interdisciplinario de la esclerosis múltiple

Objective

To assess the impact of physical, psychological and autonomy conditions of persons with multiple sclerosis (PwMS) through an Adapted Aquatics Actitvity Program (AAAP).

Methods

Twenty-five outpatients (twenty-four with MS and one with an amyothrophic lateral sclerosis) from the MS Day Hospital were included in the AAAP. The program consisted of 12 one-hour weekly consecutive sessions.

Clinical data were: 54.2 % of patients had a relapsing-remitting MS, 33.3 % had a secondary progressive MS and 12.5 % had a primary progressive MS. 68 % were female and 32 % were male; mean age: 45; mean Kurtzke Expanded Disability Status Scale (EDSS): 4.5 The range of scores for 12.5 % of the patients was 1.0 to 3.5 and 4.0 to 6.5 for the rest.

Measurements assessed at the beginning and at the end of the period of treatment were EDSS, the modified Ashworth Scale, the Oxford test, the Tinetti Test on walking, the modified Rivermead Mobility Index, the Motor Assessment Scale and a self satisfaction questionnaire.

Results

A statistically significant improvement was observed in the gait pattern (Wilcoxon; z = −2.754, p = 0.006) and in the strength of the lower limbs (Kolmogorov-Smirnov; z = 1.874, p = 0.002).

The Tinetti score with the subjective fatigue degree score correlated significantly (U de Mann-Whitney; p = 0.005).

Conclusions

The results suggested that our program is beneficial using both objective and subjective scores. In spite of the results, most participants did not continue with the AAAP as a health activity because of arquitectural barriers. More resources should be provided to eliminate such barriers in order to promote autonomy in handicapped PwMS.