| Abstrakt | | Multiple sclerosis (MS) is a chronic disabling condition which affects people in their early adult life and as a result has major socioeconomic implications. Although it is an unpredictable conditon, disability develops over time in the majority of patients. As a result patients have different needs depending on the stage of their condition. Long term management requires a model of care which addresses these needs in a flexible and comprehensive way. Two particularly important stages are the time of diagnosis and when patients develop significant disability. Much of the rehabilitation input is concentrated on the latter stage and can be divided into symptomatic management and neurorehabilitaiton. Symptomatic management addresses such problems as spasticity, bladder dysfunction and fatigue. Neurorehabilitation incorporates symptomic management but aims to treat the patient in an integrated, comprehensive way. As MS is a progressive disorder, rehabilitation input needs to be focused. The key components of this streategy are: - expert multidisciplinary assessment; - the identification of areas of functional imrpovement; - precise goal setting; - the measurement of autcome, both in relation to goal achievement and changes in disability, handicap and quality of life. In addressing the issue of long term management the mechanism of delivery of care is crucial. Ideally this should be community based with access to both inpatient and outpatient rehabilitation units. Such an ideal model of care has not been achieved in any European country but the last five years have seen encouraging developments in parallel with therapeutic advances.
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