Abstract

Disease-modifying drugs have mostly failed as treatments for progressive multiple sclerosis. Management of the disease therefore solely aims to minimise symptoms and, if possible, improve function. The degree to which this approach is based on empirical data derived from studies of progressive disease or whether treatment decisions are based on what is known about relapsing-remitting disease remains unclear. Symptoms rated as important by patients with multiple sclerosis include balance and mobility impairments, weakness, reduced cardiovascular fitness, ataxia, fatigue, bladder dysfunction, spasticity, pain, cognitive deficits, depression, and pseudobulbar affect; a comprehensive literature search shows a notable paucity of studies devoted solely to these symptoms in progressive multiple sclerosis, which translates to few proven therapeutic options in the clinic. A new strategy that can be used in future rehabilitation trials is therefore needed, with the adoption of approaches that look beyond single interventions to concurrent, potentially synergistic, treatments that maximise what remains of neural plasticity in patients with progressive multiple sclerosis.

DOI

10.1016/S1474-4422(14)70231-5

Publication Date

2015-02-01

Publication Title

Lancet Neurol

Volume

14

Issue

2

Organisational Unit

School of Health Professions

Keywords

Animals, Depression, Exercise Therapy, Health Services Needs and Demand, Humans, Immunologic Factors, Multiple Sclerosis, Muscle Fatigue, Physical Therapy Modalities, Treatment Outcome

First Page

194

Last Page

207

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