A NEW ADL ASSESSMENT IN MULTIPLE SCLEROSIS - THE SHEBA OTS
S. Gat, Z. Rotstein, Y. Barak, A. Achiron.
Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel
Purpose: Occupational therapy is one of the main rehabilitation approaches used in patients suffering from chronic disabilities. In order to assess and quantify disability in patients with multiple sclerosis we have developed an occupational therapy oriented comprehensive rating scale for ADL tasks (Sheba-OTS).
Methods: The scale includes 9 functional systems covering the following functions of daily activities: dressing, washing, eating & drinking, hygiene, mobility, transfer, simple and difficult household chores, and others. The performance of each activity is graded according to quality, time and independence, between 1 (best) to 4 (worst) and a mean total score is calculated.
Results: Ten patients with multiple sclerosis were assessed by the Sheba-OTS and underwent neurological examination scored by the Expanded Disability Status Scale (EDSS). Mean combined Sheba-OTS score was 2.4 for time, 2.45 for quality, and 2,1 for independence. Correlation between EDSS and Sheba-OTS performance were significant only for independence (p<0.05).
Conclusions: We tentatively conclude that neurological disability in MS patients is correlated with the ability to independently carry out ADL. Since time to complete tasks and quality of performance do not correlate with the EDSS, the need for specific Sheba-OTS assessment in MS patients is underscored.
The effect of short-term physiotherapy on disability of multiple sclerosis patients
Nitzani D, Grossman R, Isar T, A. Achiron.
Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel.
Purpose: To evaluate the effect of short-term physiotherapy on disability of multiple sclerosis (MS) patients.
Methods: Twenty MS patients with moderate neurological disability underwent a short-term physiotherapy program of 4 weeks duration oriented to reduce spasticity and improve muscle strength and instability. Assessment included neurological examination according to the Expanded Disability Status Scale (EDSS) and the time needed for walking a distance of 20 meters.
Results: Short-term physiotherapy significantly improved disability in 18/20 of patients included in the program. The mean time of 20 meters distance walking decreased from 71.3±51.3 sec to 57±45.9, (p=0.036). Improvement was mainly related to reduced spasticity and increased muscle strength.
Conclusions: Short-term physiotherapy is recommended to improve MS patients with moderate disability.