Telerehabilitation for persons with multiple sclerosis. A Cochrane review

Area of Science:

• Neurology
• Rehabilitation Medicine
• Digital Health

Background:

• Telerehabilitation interventions are increasingly used for multiple sclerosis (MS).
• Evidence regarding the effectiveness of these interventions remains unclear.
• A systematic review is needed to assess current evidence on telerehabilitation for pwMS.

Purpose of the Study:

• To systematically review the effectiveness and safety of telerehabilitation interventions in people with multiple sclerosis (pwMS).
• To identify effective telerehabilitation approaches, including setting, type, and intensity.
• To determine the impact on various outcomes like impairment, activity limitation, and participation.

Main Methods:

• Systematic search of the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System Review Group Specialised Register.
• Screening of relevant journals and reference lists for additional studies.
• Inclusion of randomized controlled trials (RCTs) comparing telerehabilitation with control interventions.
• Best evidence synthesis using GRADEpro for methodological quality assessment.

Main Results:

• Nine RCTs involving 531 participants were analyzed, with low methodological quality.
• Low-level evidence suggests short-term reduction in disability and symptoms like fatigue.
• Low-level evidence supports longer-term improvements in functional activities, impairments, and participation.

Conclusions:

• Limited evidence supports telerehabilitation for improving functional activities, fatigue, and quality of life in adults with MS.
• Insufficient evidence exists regarding optimal telerehabilitation types and settings.
• More high-quality trials are required to establish clinical and cost-effectiveness.