Task-oriented training for upper limb functions in patients with multiple sclerosis: Systematic review and meta-analysis

Patients with multiple sclerosis (MS) typically experience varying degrees of impairments and disabilities. Task-oriented training (TOT) has been used for those patients to improve their motor skills. This review aimed to evaluate the primary research on the effectiveness of TOT in improving upper limb functions in patients with MS. The systematic search was performed using PubMed, Cochrane library and Physical therapy Evidence Database (PEDro) databases up to 2022. Only randomized controlled trials that used TOT alone for UL functions of adult patients with MS were included. Two independent reviewers screened records, extracted data and assessed studies' quality by using PEDro scale. The meta-analysis was based on the standardized mean differences and the random effect. The search screened 9148 records; only five randomized controlled trials were eligible; four of them were of good quality. The trials included 147 patients with MS; 66% of them were females, their mean average age was 47 years. TOT duration ranged from 40 to 210 min with total period of 10 days to 8 weeks; it was applied alone without conventional physical therapy. Meta-analyses compared TOT alone versus control interventions revealed non-significant difference in the improvement of UL functions on Nine-Hole Peg Test, Action Reach Arm Test, Motor Activity Log-Amount Of Use scale, and Manual Ability Measurement. This review concluded that TOT alone can be effective for improving UL functions in patients with MS but meta-analyses showed non-significant differences when it was compared with conventional physical therapy.