Abstract
Objective
To assess the efficacy of physiotherapy interventions, including exercise therapy,
for the rehabilitation of people with progressive multiple sclerosis.
Data Sources
Five databases (Cochrane Library, Physiotherapy Evidence Database [PEDro], Web of
Science Core Collections, MEDLINE, Embase) and reference lists of relevant articles
were searched.
Study Selection
Randomized experimental trials, including participants with progressive multiple sclerosis
and investigating a physiotherapy intervention or an intervention containing a physiotherapy
element, were included.
Data Extraction
Data were independently extracted using a standardized form, and methodologic quality
was assessed using the PEDro scale.
Data Synthesis
Thirteen studies (described by 15 articles) were identified and scored between 5 and
9 out of 10 on the PEDro scale. Eight interventions were assessed: exercise therapy,
multidisciplinary rehabilitation, functional electrical stimulation, botulinum toxin
type A injections and manual stretches, inspiratory muscle training, therapeutic standing,
acupuncture, and body weight–supported treadmill training. All studies, apart from
1, produced positive results in at least 1 outcome measure; however, only 1 article
used a power calculation to determine the sample size and because of dropouts the
results were subsequently underpowered.
Conclusions
This review suggests that physiotherapy may be effective for the rehabilitation of
people with progressive multiple sclerosis. However, further appropriately powered
studies are required.
Keywords
List of abbreviations:
BTX-A (botulinum toxin type A), BWSTT (body weight–supported treadmill training), EDSS (Expanded Disability Status Scale), FES (functional electrical stimulation), MCID (minimum clinically important difference), MS (multiple sclerosis), PEDro (Physiotherapy Evidence Database), PPMS (primary progressive multiple sclerosis), RRMS (relapsing-remitting multiple sclerosis), SPMS (secondary progressing multiple sclerosis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 14, 2015
Footnotes
Supported by the Bevan Studentship, NHS Ayrshire and Arran.
Disclosures: none.
Identification
Copyright
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
