Rehabilitation in MS: conference report
Open Door - August 2012 pages 5
What is rehabilitation?
The aim of rehabilitation medicine is to help people regain skills and abilities lost due to MS and to help them live their life as fully as possible, minimising the impact of physical, psychological or social difficulties. Although rehabilitation is not curative, it can help you discover abilities you didn't realise you still had. It can help you make the best of, and maintain, functions in order to manage symptoms, promote independence and maintain individual choice whatever your level of disability.
RIMS (Rehabilitation in MS) is an organisation which aims to raise the profile of rehabilitation in MS in Europe and encourages the exchange of knowledge and best practise between researchers and health professionals.
The RIMS annual conference is the major European focus for new research in rehabilitation in MS. The MS Trust's Nurse Advisor, Vicki Matthews, is a RIMS committee member and a key organiser for the conference. The 2012 conference in Hamburg brought together neurologists, nurses, physiotherapists, occupational therapists, speech and language therapists and neuropsychologists from across Europe and beyond.
The conference had two main themes - shared decision making and motor rehabilitation.
Shared decision making
Shared decision making involves being an equal partner with health professionals in making choices about healthcare. While health professionals have expert knowledge on treatment options and their benefits and drawbacks, individuals are expert on their own needs and priorities. Shared decision making is a fundamental component of rehabilitation in MS, starting from working with health professionals to identify personal goals, through to agreeing a plan of therapies and monitoring progress as the plan is put into action.
The conference provided an opportunity for delegates to learn about the latest information, research and ideas on shared decision making. Key presentations on shared decision making included:
Prof Wolfgang Gaissmaier (Germany) - on the challenges of trying to communicate risk to patients making treatment decisions. He described how statistics can be presented in misleading ways and offered a range of techniques for presenting statistics in the most 'transparent' way.
Ingrid Mühlhauser (Germany) - on the challenges for health processionals in gathering the best evidence-based information to help with decision making. She stressed that people often need time to read and think about evidence and that the evidence needs to be regularly updated, which can be time consuming.
Motor rehabilitation focuses on restoring movement. Increasing evidence suggests that certain rehab strategies not only improve mobility by, for example, building stamina, muscle strength and joint flexibility, but can also have a direct effect on brain structure and function. Neuroplasticity is the process by which the brain is able to adapt and compensate for damage to specific areas. Presentations gave an update on current understanding of neuroplasticity and included:
Prof Joseph Classen (Germany) - on innovations in measuring neuroplasticity. This knowledge can help to identify more effective rehabilitation techniques.
Prof Alan Thompson (UK) - on structural changes in the components of the central nervous system involved in movement and their regeneration. Studies have shown that people with MS need to use more of the brain in order to do a task. fMRI - a brain scan which measure brain activity - has shown that people with MS who have good cognitive skills have more areas and more intensity of brain activity than people with more cognitive difficulties. Current research is directed towards helping people to harness neuroplasticity.