Physiotherapy Rehabilitation for People With Progressive Multiple Sclerosis: A Systematic Review.
OBJECTIVE
To assess the efficacy of physiotherapy interventions, including exercise therapy, for the rehabilitation of people with progressive multiple sclerosis.


METHODS
Five databases (Cochrane Library, Physiotherapy Evidence Database [PEDro], Web of Science Core Collections, MEDLINE, Embase) and reference lists of relevant articles were searched.


METHODS
Randomized experimental trials, including participants with progressive multiple sclerosis and investigating a physiotherapy intervention or an intervention containing a physiotherapy element, were included.


METHODS
Data were independently extracted using a standardized form, and methodologic quality was assessed using the PEDro scale.


RESULTS
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.
School of Medicine, The University of Glasgow, Glasgow, Scotland. Electronic address: e.campbell.4@research.gla.ac.uk.
Evan
E
Campbell
School of Medicine, The University of Glasgow, Glasgow, Scotland.
Elaine H
EH
Coulter
Multiple Sclerosis Service, NHS Ayrshire and Arran, Irvine, Scotland.
Paul G
PG
Mattison
Multiple Sclerosis Service, NHS Ayrshire and Arran, Irvine, Scotland; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland.
Linda
L
Miller
AKM-Stats, Statistical Consultant, Glasgow, Scotland.
Angus
A
McFadyen
School of Medicine, The University of Glasgow, Glasgow, Scotland.
Lorna
L
Paul
D015670:Acupuncture Therapy; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D006801:Humans; D020528:Multiple Sclerosis, Chronic Progressive / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic
D019274:Botulinum Toxins, Type A
Exercise; Multiple sclerosis; Physical therapy modalities; Rehabilitation; Review [publication type]