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||Khan, F., & Amatya, B. (2017). Rehabilitation in multiple sclerosis: A systematic review of systematic reviews. Archives of Physical Medicine and Rehabilitation, 98(2), 353-367.
||Intervention, literature reviews, multiple sclerosis, outcomes, rehabilitation research, rehabilitation services, research reviews
||Study systematically evaluated existing evidence from published systematic reviews of clinical trials to determine the effectiveness of rehabilitation for improving function and participation in people with multiple sclerosis (MS). A literature search was conducted using medical and health science electronic databases up to January 31, 2016. Of the 214 potential systematic reviews evaluating rehabilitation intervention used for MS, 53 met the abstract inclusion criteria and were selected for full review. Data were summarized for type of interventions, type of study designs included, outcome domains, method of data synthesis, and findings. Two reviewers independently assessed methodological quality using the Assessment of Multiple Systematic Reviews. Quality of evidence was critically appraised with the Grades of Recommendation, Assessment, Development, and Evaluation. 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. 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.
|Full-Text Availability Options:||https://www.ncbi.nlm.nih.gov/pubmed/27216225|