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The benefits of an extended outpatient rehabilitation programme for severely impaired patients with progressive MS was described by DiFabio et al (1998). The purpose of the programme was to maintain physical functioning and to improve coping skills. In addition to physical and occupational therapy, there were extensive support services, including support groups, social work, therapeutic recreation, seating and positioning clinics, nutritional education, and wound and fall prevention programmes. Participants met once weekly for a 5-hour session for a full year. Two groups were assessed, the treatment group consisting of 20 patients, and the comparison group consisting of 26 patients remaining on a waiting list. After 1 year, the patients who had participated in the outpatient rehabilitation programme experienced fewer symptoms, had less fatigue, and showed a lower rate of decline in physical functioning than did subjects on the waiting list.

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