Article

OBJECTIVES: To systematically evaluate existing evidence from published
systematic reviews of clinical trials for the effectiveness of rehabilitation for
improving function and participation in persons with multiple sclerosis (MS).
DATA SOURCES: A literature search was conducted using medical and health science
electronic databases (MEDLINE, EMBASE, CINAHL, PubMed, Cochrane Library) up to
January 31, 2016.
STUDY SELECTION: Two reviewers independently applied inclusion
criteria to select potential systematic reviews assessing the effectiveness of
organized rehabilitation for persons with MS. Data were summarized for type of
interventions, type of study designs included, outcome domains, method of data
synthesis, and findings. DATA EXTRACTION: Data were extracted by 2 reviewers
independently for methodological quality using the Assessment of Multiple
Systematic Reviews. Quality of evidence was critically appraised with the Grades
of Recommendation, Assessment, Development, and Evaluation. DATA SYNTHESIS:
Thirty-nine systematic reviews (one with 2 reports) evaluated best evidence to
date. There is "strong" evidence for physical therapy for improved activity and
participation, and for exercise-based educational programs for the reduction of
patient-reported fatigue. There is "moderate" evidence for multidisciplinary
rehabilitation for longer-term gains at the levels of activity (disability) and
participation, for cognitive-behavior therapy for the treatment of depression,
and for information-provision interventions for improved patient knowledge. There
is "limited" evidence for better patient outcomes using psychological and symptom
management programs (fatigue, spasticity). For other rehabilitation
interventions, the evidence is inconclusive because of limited methodologically
robust studies. CONCLUSIONS: Despite the range of rehabilitative treatments
available for MS, there is a lack of high-quality evidence for many modalities.
Further research is needed for effective rehabilitation approaches with
appropriate study design, outcome measurement, type and intensity of modalities,
and cost-effectiveness of these interventions.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS