Rehabilitation still the only way to improve function in multiple sclerosis

2have shown widespread axon damage in MS, so remye lination alone would not be sufficient to restore all the function lost. F urthermore, e ven if there were a therapy that could fully prevent progression of the disease, h undreds of thousands of patients worldwide would still be left with residual neurological damage and the associat ed impairment and disability. As a result, r ehabilitative techniques must be used to reduce disability and handicap. Assessment of MS patients should thus include a detailed eva luation of physical, p sychological, vo cational, and social functioning. 3 At times, disability may be reduced pharmacologically (eg, the use of spasmolytic drugs in the presence of clonus-produced footdrop, ox ybutynin to improve bladder function, or 4-aminopyridine to improve strength), although such therapies must be accompanied by physical measures such as the stretching of tight and spastic muscles. 4 To some extent, s trength may be increased with resistive exe rcises, 5 and