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An Interview with George Kraft, MD

Photo of George Kraft, MD

The Multiple Sclerosis Rehabilitation Research and Training Center (MSRRTC) strives to contribute to new and important research about ways to improve function for people with MS using rehabilitation. The Center also aims to further understand the impact that MS has on people’s everyday lives in order to create better measurement of, and response to the most important issues for people with MS.

George Kraft, MD, Professor, and Co-PI for the MSSRTC was kind enough to answer a few questions about the interdisciplinary center.

When did the MSRRTC start?

We just received a competitive renewal from the National Institute on Disability and Rehabilitation Research for the third cycle of five year funding, which means that the MSRRTC officially started in 1998. However, the tradition of research on MS rehabilitation started here at the UW with survey research of people with MS in the late 1970’s.

Why do you feel it important to focus on rehabilitation for people with Multiple Sclerosis?

I published an article in the Lancet in late 2000 entitled “Rehabilitation still the only way to improve function in multiple sclerosis,” and that still holds true today. The recent development of disease-modifying drugs has not eliminated the need for rehabilitative strategies in the management of multiple sclerosis (MS).

Rehabilitative techniques can improve function and reduce handicaps, allowing people with MS to live their lives as independently as possible. In fact, inpatient rehabilitation improves functioning even when neurological status does not improve.

What are some of the MSRRTC’s current research initiatives?

We have some very exciting research initiatives coming up because of our grant renewal in October of 2008. We will be continuing our longitudinal survey, which is integral in understanding the effects that multiple sclerosis has on individuals over time.

We will also be administering a telephone based counseling intervention to help people with MS self manage their symptoms in healthy and constructive ways and disseminating the intervention to organizations like the National MS Society in helpful and easy to replicate modules.

Finally, we will be studying employment and MS to better understand the way the disability affects people’s work lives, and how to provide assistance that will help both the employee with MS and his or her employer.

What are the most exciting breakthroughs that have resulted from research conducted by the MSRRTC?

This is a good question that we should all be asking ourselves—are we doing something important? There is a distinction between research with impact and important research, and I think we are doing both at the MSRRTC. Time is necessary for research to have an impact on the wider community, and by that token, important research may not have an impact for years after it is accomplished.

Along those lines, I think the research I’ve been involved with that has had the most impact is the discovery of fatigue as a symptom of MS. Before our publications on this in the early 1980’s, fatigue was never mentioned as a symptom of the disease. Now, it is universally recognized as the most common symptom of MS.

We published the first paper on fatigue in MS in 1984; this has now been cited 215 times (a very high impact factor). This established the tradition of MS rehabilitation research at the University of Washington that the Center proudly carries on.

I believe the most important of the contemporary research is the concept of the “paradigm shift” in MS research to include hidden disabilities, which include fatigue and cognitive problems that interact with each other to make each problem worse than it would be alone. This is an important concept that has changed the way MS is viewed both by the research community and by the public.

Among many articles, abstracts and publications published and presented, it looks like the team has published the book, The MS Workbook: Living Fully with Multiple Sclerosis. Has the MSRRTC published any other books?

In addition to the MS Workbook, the Center has also published, Living with Multiple Sclerosis: A Wellness Approach and Multiple Sclerosis: A Paradigm Shift. These are all important works that are still selling well; 100% of the royalties from the Workbook go towards promoting further research at the Center.

And, we now have a regular column in Momentum, a quarterly publication by the National MS Society that has a circulation of over 500,000 copies.

Does the MSRRTC grant make our MS fellowship possible?

The MS fellowship is a spin-off from the Center. The MS Center has paved the way for several departmental oppotrunities, including the fellowship, MS research grants, Dr. Dawn Ehde’s research fellowship, and donor contributions among other things.

The MS clinician fellowship started in July of 2001, and since then we have trained eight fellows.

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