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. 2022 Jul 11:2022:2357785.
doi: 10.1155/2022/2357785. eCollection 2022.

The Effectiveness of Physiotherapy Interventions for Mobility in Severe Multiple Sclerosis: A Systematic Review and Meta-Analysis

Tarub Binshalan  1   2 , Krishnan Padmakumari Sivaraman Nair  1 , Alisdair McNeill  1
Affiliations

The Effectiveness of Physiotherapy Interventions for Mobility in Severe Multiple Sclerosis: A Systematic Review and Meta-Analysis

Tarub Binshalan et al. Mult Scler Int. .

Abstract

Background: People with Multiple Sclerosis (pwMS) prioritise gait as the most valuable function to be affected by MS. Physiotherapy plays a key role in managing gait impairment in MS. There is little evidence on the effectiveness of physiotherapy for severe MS.

Objective: To undertake a systematic review and meta-analysis of the literature to identify evidence for the effectiveness of physiotherapy for gait impairment in severe MS. Methods. The available literature was systematically searched, using a predetermined protocol, to identify research studies investigating a physiotherapy intervention for mobility in people with severe MS (EDSS ≥ 6.0). Data on mobility related endpoints was extracted. Meta-analysis was performed where a given mobility end point was reported in at least 3 studies.

Results: 37 relevant papers were identified, which included 788 pwMS. Seven mobility-related endpoints were meta-analysed. Robot-Assisted Gait Training (RAGT) was found to improve performance on the 6-minute walk test, 10-metre walk test, fatigue severity scale, and Berg Balance Scale. Neither body weight supported training nor conventional walking training significantly improved any mobility-related outcomes.

Conclusion: Physiotherapy interventions are feasible for mobility in severe MS. There is some evidence for the effectiveness of RAGT.

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Conflict of interest statement

There are no financial or other conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart (2020). ∗Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers). ∗∗If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools. From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372:n71. doi: 10.1136/bmj.n71. For more information, visit: http://www.prisma-statement.org/
Figure 2
Figure 2
Standardised mean differences in (a) 6MWT and (b) 10MWT post-RAGT.
Figure 3
Figure 3
Standardised mean differences in (a) TUG, (b) FSS, and (c) BBS post-RAGT.
Figure 4
Figure 4
Standardised mean differences: (a) 25-foot walk test after body weight-supported training and (b) 6MWT postconventional walking training.
See this image and copyright information in PMC

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