Review article (meta-analysis)Rehabilitation in Multiple Sclerosis: A Systematic Review of Systematic Reviews
Section snippets
Methods
A comprehensive search of the Cochrane Library database (including Database of Abstracts and Reviews of Effectiveness), MEDLINE, CINAHL, EMBASE, and PubMed was undertaken till January 31, 2016 for systematic reviews evaluating rehabilitation interventions currently used in the management of pwMS. The search strategy included combinations of multiple search terms for 2 themes: MS and interventions (rehabilitation). The keywords used to search for studies for this review are listed in appendix 1.
Results
The search retrieved 214 published systematic reviews evaluating rehabilitation interventions currently used in management of MS. Of these, 53 reviews met the abstract inclusion criteria and were selected for closer scrutiny. Full texts of these articles were retrieved, and both reviewers performed the final selection. One review that met the inclusion criteria was identified from the bibliographies of relevant articles. Overall, 15 reviews published in the Cochrane Library database and 24 (one
Discussion
MS is a complex condition, and pwMS frequently present with multiple deficits (motor, sensory, cognitive, behavioral, and communication issues), which require specific and coordinated longer-term multidisciplinary rehabilitative care. This review systematically summarizes the best up-to-date evidence from published systematic reviews for the effectiveness of rehabilitation interventions in MS. The findings indicate that, although a broad range of rehabilitative approaches have been trialed in
Conclusions
MS requires specialized, flexible services for comprehensive management. There is increasing awareness of the contribution of rehabilitation in early and long-term MS care. Despite the range of rehabilitative interventions in pwMS, evidence for many is still unclear because of a lack of methodologically robust trials. More research is needed to build evidence for types of rehabilitation therapy components, modalities, and the duration and setting of therapy. Future research should focus on
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Supported by the internal resources of the Rehabilitation Department, Royal Melbourne Hospital, Royal Park Campus, Melbourne, Australia.
Disclosures: none.