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Weigel M, Hutchinson B, Magee WL, Leong K, Sweitzer T, Weiss JL, Su W, Fleming R. Orchestrating a New Path for Multiple Sclerosis: Achieving Physical, Cognitive, and Emotional Rehabilitation Goals Through Physical and Music Therapy. Int J MS Care 2023; 25:168-175. [PMID: 37469330 PMCID: PMC10353696 DOI: 10.7224/1537-2073.2021-144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Interdisciplinary therapies for the management of people with multiple sclerosis (MS) are underappreciated. There is an urgent need to introduce music therapy (MT), either alone or in combination with physical therapy (PT), into clinical practice to achieve synergy with disease-modifying therapies. A holistic approach to rehabilitation for people with MS may mitigate symptoms and reduce polypharmacy, potentially lowering health care costs. RESULTS As MS progresses, patients experience a range of worsening symptoms, and many develop psychosocial comorbidities. As disease-modifying therapies delay disability progression, nonpharmacologic treatments become increasingly important. The main aim of PT is to improve or maintain patients' functional mobility, strength, and flexibility. Because it targets multiple functions, MT can help improve functional and psychosocial domains and may be a valuable intervention to help patients achieve the physical, cognitive, and emotional goals of PT. Exploratory studies showed that MT, alone or in combination with PT, can lead to functional improvements in mobility, balance, gait, and fatigue. Similar to PT, MT also has benefits in improving fine motor skills, cognition, learning, and memory and in providing emotional support. CONCLUSIONS Both MT and PT have the potential to improve overall well-being and health-related quality of life in physically active patients with MS, and MT can provide added emotional support for those who are less able to engage in physical activity. However, MT is not typically a part of standard of care, and PT visits are limited. Nevertheless, interdisciplinary therapies should be incorporated into clinical practice.
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Affiliation(s)
- Megan Weigel
- From First Coast Integrative Medicine, Jacksonville Beach, FL, USA (MW)
| | | | - Wendy L. Magee
- Boyer College of Music and Dance, Temple University, Philadelphia, PA, USA (WLM)
| | | | | | - Jamie L. Weiss
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA (JLW, WS)
| | - Wendy Su
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA (JLW, WS)
| | - Renée Fleming
- John F. Kennedy Center for the Performing Arts, Washington, DC, USA (RF)
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Řasová K, Martinková P, Vařejková M, Miznerová B, Pavlíková M, Hlinovská J, Hlinovský D, Philippová Š, Novotný M, Pospíšilová K, Biedková P, Vojíková R, Havlík J, O'Leary VB, Černá M, Bartoš A, Philipp T. COMIRESTROKE—A clinical study protocol for monitoring clinical effect and molecular biological readouts of COMprehensive Intensive REhabilitation program after STROKE: A four-arm parallel-group randomized double blinded controlled trial with a longitudinal design. Front Neurol 2022; 13:954712. [DOI: 10.3389/fneur.2022.954712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022] Open
Abstract
IntroductionWhile the role of physiotherapy as part of a comprehensive inpatient rehabilitation is indisputable, clear evidence concerning the effectiveness of different rehabilitation managements [interdisciplinary implementing the International Classification of Functioning, disability and health (ICF) vs. multidisciplinary model] and physiotherapy categories (neuroproprioceptive “facilitation, inhibition” vs. motor/skill acquisitions using technologies) are still lacking. In this study, four kinds of comprehensive inpatient rehabilitation with different management and content of physical therapy will be compared. Moreover, focus will be placed on the identification of novel biological molecules reflective of effective rehabilitation. Long non-coding RNAs (lncRNAs) are transcripts (>200 bps) of limited coding potential, which have recently been recognized as key factors in neuronal signaling pathways in ischemic stroke and as such, may provide a valuable readout of patient recovery and neuroprotection during therapeutic progression.Methods and analysisAdults after the first ischemic stroke in an early sub-acute phase with motor disability will be randomly assigned to one of four groups and undergo a 3 weeks comprehensive inpatient rehabilitation of different types: interdisciplinary team work using ICF model as a guide; multidisciplinary teamwork implementing neuroproprioceptive “facilitation and inhibition” physiotherapy; multidisciplinary teamwork implementing technology-based physiotherapy; and standard multidisciplinary teamwork. Primary (the Goal Attainment Scale, the Patient-Reported Outcomes Measurement Information System, and the World Health Organization Disability Assessment Schedule) and secondary (motor, cognitive, psychological, speech and swallowing functions, functional independence) outcomes will be measured. A blood sample will be obtained upon consent (20 mls; representing pre-rehabilitation molecular) before and after the inpatient program. Primary outcomes will be followed up again 3 and 12 months after the end of the program. The overarching aim of this study is to determine the effectiveness of various rehabilitation managements and physiotherapeutic categories implemented by patients post ischemic stroke via analysis of primary, secondary and long non-coding RNA readouts. This clinical trial will offer an innovative approach not previously tested and will provide new complex analysis along with public assessable molecular biological evidence of various rehabilitation methodology for the alleviation of the effects of ischemic stroke.Clinical trial registrationNCT05323916, https://clinicaltrials.gov/ct2/show/NCT05323916.
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Brenner R, Witzig-Brändli V, Vetsch J, Kohler M. Nursing Interventions Focusing on Self-efficacy for Patients With Multiple Sclerosis in Rehabilitation: A Systematic Review. Int J MS Care 2022; 24:189-198. [PMID: 35875457 DOI: 10.7224/1537-2073.2021-166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Rehabilitative nursing interventions are vital in the treatment of multiple sclerosis (MS), but there is a lack of evidence on the effectiveness of such interventions. This review aims to summarize outcomes of nurse-led rehabilitation interventions for patients with MS, focusing on patients' self-efficacy and self-management and their satisfaction with the intervention. This review is the first step of our overarching goal of developing, implementing, and evaluating a research-supported nursing consultation intervention in inpatient rehabilitation. METHODS We searched 3 databases from their dates of inception until April 2020 (and performed another search in August 2021) for studies involving adult patients diagnosed as having MS. We focused on studies with interventions aimed at self-efficacy and self-management of MS and studies on intervention satisfaction. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS We included 4 studies in this review with a total of 271 participants. All interventions were educational and included training programs. All studies assessed self-efficacy, and all identified an improvement in self-efficacy, particularly through group training interventions. One study focused on self-management, reporting an improvement resulting from the intervention. Two studies evaluating satisfaction with the intervention obtained good overall satisfaction scores from participants, and 1 study's program was strongly recommended by participants. CONCLUSIONS This review indicates that self-efficacy and self-management abilities may be effectively promoted, particularly through group training interventions. An intervention tailored and adapted to the needs of patients with MS may promote satisfaction with the intervention and might consequently improve adherence to rehabilitation interventions.
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Affiliation(s)
- Rouven Brenner
- Department of Health, Eastern Switzerland University of Applied Sciences, St Gallen, Switzerland (RB, VW-B, JV, MK)
| | - Verena Witzig-Brändli
- Department of Health, Eastern Switzerland University of Applied Sciences, St Gallen, Switzerland (RB, VW-B, JV, MK)
| | - Janine Vetsch
- Department of Health, Eastern Switzerland University of Applied Sciences, St Gallen, Switzerland (RB, VW-B, JV, MK)
| | - Myrta Kohler
- Department of Health, Eastern Switzerland University of Applied Sciences, St Gallen, Switzerland (RB, VW-B, JV, MK)
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Kuspinar A, Bello-Haas VD, Liu D, Essah K, Cao L, Ploughman M. Use of Participatory Action Research in the Development of a Survey of Physiotherapy Services for People with Multiple Sclerosis in Canada. Physiother Can 2020; 72:366-373. [DOI: 10.3138/ptc-2019-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Currently, there is a paucity of research describing physiotherapy services for individuals with multiple sclerosis (MS) in Canada. Using qualitative methods, we aimed to develop a survey to examine physiotherapy practice patterns for people with MS receiving services in Canada. Method: We began by conducting a review of the current literature and combining participatory action research methods with the expertise of registered physiotherapists and individuals with MS. Semi-structured interviews were conducted with 10 participants to obtain their input into survey development. The interviews were then transcribed verbatim and analyzed thematically. Results: Five key themes emerged from the thematic analysis: (1) provide additional answer options, (2) reformat or clarify questions, (3) ensure that questions or options are appropriate, (4) ensure good readability and flow, and (5) determine the appropriate length of the survey. After a final revision, the survey consisted of 24 items in the following domains: demographics, MS programme and patient population, interdisciplinary care, and programme and service barriers. Conclusions: This survey is the first of its kind in Canada and is the first step toward improving the quality of health of people living with MS and the effectiveness of current physiotherapy practices for them.
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Affiliation(s)
- Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, Ont.
| | | | - Diana Liu
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Nfld
| | - Karen Essah
- School of Rehabilitation Science, McMaster University, Hamilton, Ont.
| | - Lily Cao
- School of Rehabilitation Science, McMaster University, Hamilton, Ont.
| | - Michelle Ploughman
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Nfld
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Řasová K, Martinková P, Soler B, Freeman J, Cattaneo D, Jonsdottir J, Smedal T, Romberg A, Henze T, Santoyo-Medina C, Feys P. Real-World Goal Setting and Use of Outcome Measures According to the International Classification of Functioning, Disability and Health: A European Survey of Physical Therapy Practice in Multiple Sclerosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134774. [PMID: 32630765 PMCID: PMC7369767 DOI: 10.3390/ijerph17134774] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/27/2020] [Accepted: 06/30/2020] [Indexed: 01/29/2023]
Abstract
Goal setting is a core component of physical therapy in multiple sclerosis (MS). It is unknown whether and to what extent goals are set at different levels of the International Classification of Functioning, Disability and Health (ICF), and whether, and to which, standardized outcome measures are used in real life for evaluation at the different ICF levels. Our aim was to describe the real-world use of goal setting and outcome measures in Europe. An online cross-sectional survey, completed by 212 physical therapists (PTs) specialized in MS from 26 European countries, was conducted. Differences between European regions and relationships between goals and assessments were analyzed. PTs regularly set goals, but did not always apply the Specific, Measurable, Achievable, Realistic, Timed (SMART) criteria. Regions did not differ in the range of activities assessed, but in goals set (e.g., Western and Northern regions set significantly more goals regarding leisure and work) and outcome measures used (e.g., the Berg Balance Scale was more frequently used in Northern regions). Quality of life was not routinely assessed, despite being viewed as an important therapy goal. Discrepancies existed both in goal setting and assessment across European regions. ICF assists in understanding these discrepancies and in guiding improved health-care for the future.
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Affiliation(s)
- Kamila Řasová
- Department of Rehabilitation, Third Faculty of Medicine, Charles University, Prague 108 00, Czech Republic
- Correspondence: ; Tel.: +420-60-4511-416
| | - Patrícia Martinková
- Department of Statistical Modelling, Institute of Computer Science of the Czech Academy of Sciences, Prague 182 07, Czech Republic;
| | - Bernadita Soler
- Neurology, Pontificia Universidad Católica de Chile, Santiago 3580000, Chile;
- Neurology, Hospital Doctor Sótero del Rio, Santiago 8320000, Chile
- REVAL, Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt 3500, Belgium;
| | - Jenny Freeman
- Faculty of Health, University of Plymouth, Devon PL6 8BH, UK;
| | - Davide Cattaneo
- IRCCS Fondazione Don Carlo Gnocchi, Larice Lab, 20148 Milan, Italy; (D.C.); (J.J.)
| | - Johanna Jonsdottir
- IRCCS Fondazione Don Carlo Gnocchi, Larice Lab, 20148 Milan, Italy; (D.C.); (J.J.)
| | - Tori Smedal
- Norwegian Multiple Sclerosis Competence Centre, Department of Neurology and Department of Physiotherapy, Haukeland University Hospital, 5021 Bergen, Norway;
| | - Anders Romberg
- Physiotherapy, Masku Neurological Rehabilitation Centre, 21250 Masku, Finland;
| | - Thomas Henze
- Specialist Practice in Neurology, 93059 Regensburg, Germany;
| | - Carme Santoyo-Medina
- Neurology-Neuroimmunology Department, Neurorehabilitation Unit, Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d’Hebron University Hospital, 08035 Barcelona, Spain;
| | - Peter Feys
- REVAL, Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt 3500, Belgium;
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Řasová K, Freeman J, Cattaneo D, Jonsdottir J, Baert I, Smedal T, Romberg A, Feys P, Alves-Guerreiro J, Habek M, Henze T, Santoyo-Medina C, Beiske A, Van Asch P, Bakalidou D, Salcı Y, Dimitrova E, Pavlíková M, Štětkářová I, Vorlíčková J, Martinková P. Content and Delivery of Physical Therapy in Multiple Sclerosis across Europe: A Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E886. [PMID: 32023868 PMCID: PMC7038126 DOI: 10.3390/ijerph17030886] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 12/25/2022]
Abstract
Background: Guidelines and general recommendations are available for multiple sclerosis rehabilitation, but no specific guidance exists for physical therapists. Describing aspects of physical therapy content and delivery in multiple sclerosis and its determinants and analysing whether general recommendations connected with physical therapy are implemented in practice is important for interpreting clinical and research evidence. Methods: An online cross-sectional survey of physical therapists specialized in multiple sclerosis (212 specialists from 26 European countries) was used. Results: There was distinct diversity in service delivery and content across Europe. Perceived accessibility of physical therapy varied from most accessible in the Western region, and least in the Southern region. Sixty-four physical therapists adjusted their approach according to different disability levels, less so in the Eastern region. Duration, frequency and dose of sessions differed between regions, being highest in Southern and Western regions. "Hands on treatment" was the most commonly used therapeutic approach in all apart from the Northern regions, where "word instruction" (providing advice and information) prevailed. Conclusions: The content and delivery of physical therapy differs across Europe. Recommendations concerning access to treatment and adjustment according to disability do not appear to be widely implemented in clinical practice.
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Affiliation(s)
- Kamila Řasová
- Department of Rehabilitation, Third Faculty of Medicine, Charles University, Ruská 87, 108 00 Prague, Czech Republic;
| | - Jenny Freeman
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Devon PL6 8BH, UK;
| | - Davide Cattaneo
- IRCCS Fondazione Don Carlo Gnocchi, Larice Lab, P20148 Milan, Italy; (D.C.); (J.J.)
| | - Johanna Jonsdottir
- IRCCS Fondazione Don Carlo Gnocchi, Larice Lab, P20148 Milan, Italy; (D.C.); (J.J.)
| | - Ilse Baert
- Faculty of Rehabilitation Sciences REVAL Rehabilitation Research Center REVAL, BIOMED, Hasselt University, 3500 Hasselt, Belgium;
| | - Tori Smedal
- Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, and Department of Physiotherapy, Haukeland University Hospital, 5021 Bergen, Norway;
| | - Anders Romberg
- Physiotherapy, Masku Neurological Rehabilitation Centre, 21250 Masku, Finland;
| | - Peter Feys
- Campus Diepenbeek, Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research center REVAL, BIOMED, Hasselt University, 3500 Hasselt, Belgium;
| | - Jose Alves-Guerreiro
- School of Health Sciences, Health Research Unit, Polytechnic Institute of Leiria, Campus 2-Morro do Lena-Alto do Vieiro, 2411-901 Leiria, Portugal;
| | - Mario Habek
- Department of Neurology, Referral Center for Autonomic Nervous System, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Kispaticeva, 10000 Zagreb, Croatia;
| | - Thomas Henze
- Specialist Practice in Neurology, 93059 Regensburg, Germany;
| | - Carme Santoyo-Medina
- Neurology-Neuroimmunology Department & Neurorehabilitation Unit, Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d’Hebron University Hospital, 08035 Barcelona, Spain;
| | | | - Paul Van Asch
- Fit Up, Fitness- and Physiotherapy Center, 2550 Kontich, Belgium;
| | - Daphne Bakalidou
- Department of physiotherapy, University of West Attica, Egaleo, 12243 Athens, Greece;
| | - Yeliz Salcı
- Department of Physical Therapy and Rehabilitation, Faculty of Health Science, Hacettepe University, 06100 Ankara, Turkey;
| | - Erieta Dimitrova
- Department for Rehabilitation of Musculoskeletal Disorders, Institute of Physical Medicine and Rehabilitation, Faculty of Medicine, “Ss. Cyril and Methodius” University, 1000 Skopje, Macedonia;
| | - Markéta Pavlíková
- Department of Rehabilitation, Third Faculty of Medicine, Charles University, Ruská 87, 108 00 Prague, Czech Republic;
| | - Ivana Štětkářová
- Department of Neurology, Third Faculty of Medicine, Charles University, 100 34 Prague, Czech Republic;
| | - Jana Vorlíčková
- Department of Statistical Modelling, Institute of Computer Science, Czech Academy of Sciences,18207 Prague, Czech Republic; (J.V.); (P.M.)
| | - Patricia Martinková
- Department of Statistical Modelling, Institute of Computer Science, Czech Academy of Sciences,18207 Prague, Czech Republic; (J.V.); (P.M.)
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Tsiormpatzis S. Effects of shiatsu on the health-related quality of life of a person with secondary progressive multiple sclerosis: A mixed methods N-of-1 trial within a whole systems research case study. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.101006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Kalron A, Feys P, Dalgas U, Smedal T, Freeman J, Romberg A, Conyers H, Elorriaga I, Gebara B, Merilainen J, Heric-Mansrud A, Jensen E, Jones K, Knuts K, Maertens de Noordhout B, Martic A, Normann B, O Eijnde B, Rasova K, Santoyo Medina C, Baert I. Searching for the "Active Ingredients" in Physical Rehabilitation Programs Across Europe, Necessary to Improve Mobility in People With Multiple Sclerosis: A Multicenter Study. Neurorehabil Neural Repair 2019; 33:260-270. [PMID: 30880560 DOI: 10.1177/1545968319834893] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Physical rehabilitation programs can lead to improvements in mobility in people with multiple sclerosis (PwMS). OBJECTIVE To identify which rehabilitation program elements are employed in real life and how they might affect mobility improvement in PwMS. METHODS Participants were divided into improved and nonimproved mobility groups based on changes observed in the Multiple Sclerosis Walking Scale-12 following multimodal physical rehabilitation programs. Analyses were performed at group and subgroup (mild and moderate-severe disability) levels. Rehabilitation program elements included setting, number of weeks, number of sessions, total duration, therapy format (individual, group, autonomous), therapy goals, and therapeutic approaches. RESULTS The study comprised 279 PwMS from 17 European centers. PwMS in the improved group received more sessions of individual therapy in both subgroups. In the mildly disabled group, 60.9% of the improved received resistance training, whereas, 68.5% of the nonimproved received self-stretching. In the moderately-severely disabled group, 31.4% of the improved, received aerobic training, while 50.4% of the nonimproved received passive mobilization/stretching. CONCLUSIONS We believe that our findings are an important step in opening the black-box of physical rehabilitation, imparting guidance, and assisting future research in defining characteristics of effective physical rehabilitation.
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Affiliation(s)
- Alon Kalron
- 1 Sackler Faculty of Medicine and Sagol School of Neurosciences, Tel-Aviv University, Tel-Aviv, Israel.,2 Sheba Multiple Sclerosis Center, Tel-Hashomer, Israel
| | - Peter Feys
- 3 Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | | | - Tori Smedal
- 5 Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Bergen, Norway
| | - Jennifer Freeman
- 6 Faculty of Health and Human Sciences, Plymouth University, Devon, UK
| | - Anders Romberg
- 7 Masku Neurological Rehabilitation Center, Masku, Finland
| | | | | | - Benoit Gebara
- 10 National Multiple Sclerosis Center, Melsbroek, Belgium
| | | | | | - Ellen Jensen
- 13 Multiple Sclerosis Hospital, Haslev, Denmark.,14 Multiple Sclerosis Hospital, Ry, Denmark
| | - Kari Jones
- 5 Norwegian Multiple Sclerosis Competence Centre, Haukeland University Hospital, Bergen, Norway
| | - Kathy Knuts
- 15 Rehabilitation and Multiple Sclerosis Center, Overpelt, Belgium
| | | | | | - Britt Normann
- 18 University of Tromsø the Arctic University of Norway/Nordland Hospital Trust, Bodø, Norway
| | - Bert O Eijnde
- 19 Faculty of Medicine & Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Kamila Rasova
- 20 Third Faculty of Medicine, Charles University, Prague Czech Republic
| | - Carme Santoyo Medina
- 21 Cemcat, Neurorehabilitation Unit, Vall Hebron University Hospital, Barcelona, Spain
| | - Ilse Baert
- 3 Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
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Physiotherapeutic interventions in multiple sclerosis across Europe: Regions and other factors that matter. Mult Scler Relat Disord 2018; 22:59-67. [DOI: 10.1016/j.msard.2018.03.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 01/30/2018] [Accepted: 03/04/2018] [Indexed: 11/19/2022]
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Tacchino A, Brichetto G, Zaratin P, Battaglia MA, Ponzio M. Multiple sclerosis and rehabilitation: an overview of the different rehabilitation settings. Neurol Sci 2017; 38:2131-2138. [DOI: 10.1007/s10072-017-3110-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 09/05/2017] [Indexed: 12/28/2022]
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