Effectiveness of rehabilitation for multiple sclerosis.

Unlike other areas of rehabilitation, which typically follow a single incident such as trauma or stroke and are followed by improvement (or at least an expectation of stable impairment), multiple sclerosis (MS) presents the problem of progressive impairment and disability. In addition the nature and course of this progression are variable, so that the population is heterogeneous. Expectations for outcome must be modest, and measurement should be focused on quality on life issues. On a background of pre-existing complex disability, multiple single-case (before and after) study designs often present the best evidence for effectiveness of the team approach and for specific interventions. This evidence is presented and reviewed.