MS Physical Therapy in Need of Proper Study, Experts Say

The National Multiple Sclerosis Society announced that a panel of experts led a comprehensive review of 142 published studies addressing rehabilitation in multiple sclerosis (MS), and found evidence suggesting that weekly in-home or outpatient physical therapy offers benefits — but, mostly, it found a lack of well-designed studies into MS rehabilitation therapies and techniques.

The review was published in the journal Neurology under the title, “Summary of comprehensive systematic review: Rehabilitation in multiple sclerosis.”

Rehabilitation can be critical to the health and well-being of MS patients, and significantly improve their social and vocational potentials. To take rehabilitation further and for it to be accepted by the medical and insurance industries, however, more evidence is needed from carefully designed and conducted scientific studies.

The American Academy of Neurology (AAN) is the world’s largest association of neurologists and neuroscience professionals. The panel of experts it convened analyzed comparative studies regarding multidisciplinary rehabilitation, outpatient versus inpatient physical therapy, and other techniques and programs that minimize impairment or reduce disability, all with the goal of improving the health-related quality of life for MS patients.

Researchers reported the following conclusions:

• Weekly home or outpatient physical therapy for eight weeks is likely to improve balance, disability and gait in patients able to walk five meters without assistive devices;
• Personalized inpatient exercise for three weeks, followed by home exercises for 15 weeks, is possibly effective for reducing disability;
• Motor and sensory balance training for three weeks is likely to improve patients’ balance.

Despite the identified benefits, authors believe the available data is insufficient to support or refute the use of many other programs and techniques — such as short-term aerobic exercise programs, group exercise therapy, strength training, whole body vibration exercise training, exercise training in water, cooling garments, intermittent transcranial magnetic stimulation, or balance-based torso weighting, among others.

The authors found a pressing need for optimally designed trials of rehabilitation therapies and techniques. The National MS Society is now accelerating research in the field of MS rehabilitation, making exercise and physical activity a fundamental focus of its wellness initiative. The review concluded, “We need more knowledge about how to integrate rehabilitation efficiently across the MS continuum.”