Özbaş Ezgi, Balkan Ayla Fil, Salcı Yeliz
Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06230, Ankara, Turkey.
Institute of Health Sciences, Neurology Physiotherapy Doctorate Program, Hacettepe University, 06230, Samanpazari, Ankara, Turkey.
Acta Neurol Belg. 2025 Apr;125(2):299-309. doi: 10.1007/s13760-024-02673-z. Epub 2024 Nov 1.
Balance and motor functions are associated with a complex sensory-cognitive-motor system that is not reliant on a single component. In people with Multiple Sclerosis (pwMS), deficits in cognitive domains may cause abnormal gait and balance disorders. Therefore, the impact of cognitive rehabilitation (CR) on motor and balance functions in pwMS was investigated.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review was registered in the Prospero system. A systematic search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library until April 2024. Articles meeting the eligibility criteria were assessed and included in the review, those that evaluated the impact of CR on balance and motor functions. Bias in the studies was assessed by using the Risk of Bias-2 tool for randomized controlled trials. The articles' evidence level was evaluated using the Modified Bakker Scale.
After searching four databases, eight studies were included in the review, comprising a total of 668 participants. The bias risks of the studies were categorized as low in two studies, unclear in five studies, and high in one study. The evidence levels of the studies showed high levels of evidence for balance and motor skills.
This review suggests that CR may have a positive impact on motor and balance performance in pwMS, underscoring the relationship between cognition and motor function. Further research is required to enhance this evidence base, particularly given the limited number of studies in this area.
平衡和运动功能与一个复杂的感觉-认知-运动系统相关，该系统并不依赖于单一组件。在多发性硬化症患者（pwMS）中，认知领域的缺陷可能导致异常步态和平衡障碍。因此，研究了认知康复（CR）对pwMS患者运动和平衡功能的影响。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南，该评价在Prospero系统中进行了注册。截至2024年4月，在PubMed、科学网、Scopus和Cochrane图书馆进行了系统检索。评估符合纳入标准的文章并纳入该评价，这些文章评估了CR对平衡和运动功能的影响。使用随机对照试验的偏倚风险-2工具评估研究中的偏倚。使用改良的Bakker量表评估文章的证据水平。
在检索四个数据库后，该评价纳入了八项研究，共668名参与者。两项研究的偏倚风险被归类为低，五项研究为不清楚，一项研究为高。研究的证据水平显示在平衡和运动技能方面有高水平的证据。
本评价表明，CR可能对pwMS患者的运动和平衡表现有积极影响，强调了认知与运动功能之间的关系。鉴于该领域的研究数量有限，需要进一步研究以加强这一证据基础。
