Binshalan Tarub, Nair Krishnan Padmakumari Sivaraman, McNeill Alisdair
Department of Neuroscience, The University of Sheffield, 385a Glossop Road, Sheffield, UK S10 2HQ.
College of Applied Medical Sciences, Shaqra University, Saudi Arabia.
Mult Scler Int. 2022 Jul 11;2022:2357785. doi: 10.1155/2022/2357785. eCollection 2022.
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.
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. 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.
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.
Physiotherapy interventions are feasible for mobility in severe MS. There is some evidence for the effectiveness of RAGT.
多发性硬化症患者（pwMS）将步态视为受多发性硬化症影响的最有价值的功能。物理治疗在管理多发性硬化症的步态障碍方面起着关键作用。关于严重多发性硬化症物理治疗有效性的证据很少。
对文献进行系统综述和荟萃分析，以确定物理治疗对严重多发性硬化症步态障碍有效性的证据。使用预先确定的方案对现有文献进行系统检索，以识别调查针对严重多发性硬化症患者（扩展残疾状态量表[EDSS]≥6.0）进行移动性物理治疗干预的研究。提取与移动性相关终点的数据。当至少3项研究报告了给定的移动性终点时，进行荟萃分析。
确定了37篇相关论文，其中包括788名pwMS。对7个与移动性相关的终点进行了荟萃分析。发现机器人辅助步态训练（RAGT）可改善6分钟步行试验、10米步行试验、疲劳严重程度量表和伯格平衡量表的表现。体重支持训练和传统步行训练均未显著改善任何与移动性相关的结果。
物理治疗干预对于严重多发性硬化症的移动性是可行的。有一些证据表明RAGT是有效的。
