Arsovski, Denis and Chichevska-Jovanova, Natasha and Jankulovska, Angelka and Petkovska, Daniela and Etova, Rumjana and Markova, Yanka (2026) WHEN IMPAIRMENT IS NOT ALWAYS SEEN: INVISIBLE DISABILITIES, DAILY FUNCTIONAL CHALLENGES, AND IMPLICATIONS FOR REHABILITATION IN MULTIPLE SCLEROSIS. Turkish Journal of Physiotherapy and Rehabilitation, 37 (2). pp. 136-144. ISSN 2651-446X
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Abstract
Purpose
Multiple sclerosis is a chronic immunopathological condition of the central nervous system that is characterized not only by visible motor impairments, but also by invisible symptoms such as fatigue, cognitive dysfunction and emotional problems. These invisible disabilities are often overlooked despite their impact on quality of life and independence. The aim of this research was to characterize aspects of invisible disabilities in order to inform future rehabilitation and multidisciplinary management in multiple sclerosis.
Methods
A quantitative, cross-sectional design included 660 participants with a confirmed diagnosis of multiple sclerosis. Data were collected with structured and self-administered questionnaires that assessed demographic and clinical characteristics related to fatigue, cognitive function and emotional problems. Descriptive statistics presented prevalence and severity, while Spearman’s correlation analyses and multiple linear regression analyses were used to examine associations with perceived disability.
Results
Fatigue was moderately correlated with cognitive difficulties (r=0.49, p<0.001) and emotional problems (r=0.44, p<0.001), while cognitive difficulties were moderately correlated with emotional problems (r=0.39, p<0.001). Regression analysis showed statistically significant independent associations of fatigue (p=0.005) and emotional problems (p=0.014) with perceived disability, whereas cognitive impairment was not independently associated (p=0.603).
Conclusion
Invisible symptoms, especially fatigue and emotional difficulties, cover key areas statistically associated with viewed disability in multiple sclerosis. These results show the necessity of rehabilitation that recognize invisible symptoms, serving as an initial step for developing comprehensive and multidisciplinary rehabilitation.
| Item Type: | Article |
|---|---|
| Subjects: | Scientific Fields (Frascati) > Medical and Health Sciences > Other medical sciences |
| Divisions: | Higher Medical School |
| Depositing User: | MSc Denis Arsovski |
| Date Deposited: | 24 Sep 2026 08:13 |
| Last Modified: | 24 Sep 2026 08:13 |
| URI: | https://eprints.uklo.edu.mk/id/eprint/11737 |
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