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RESEARCH PRODUCT

Effects of physiotherapy interventions on balance in multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials

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description

Objective: to determine the effects of physiotherapy inter ­ ventions on balance in people with multiple sclerosis. Data sources: A systematic literature search was conducted in Medline, cinahl, embase, PeDro, both electronically and by manual search up to March 2011. Study selection: Randomized controlled trials of physiothe­ rapy interventions in people with multiple sclerosis, with an outcome measure linked to the International Classifica­ tion of Functioning, Disability and Health (icF) category of “changing and maintaining body position”, were included. Data extraction: the quality of studies was determined by the van tulder criteria. Meta­analyses were performed in subgroups according to the intervention. Data synthesis: After screening 233 full­text papers, 11 stud­ ies were included in a qualitative analysis and 7 in a meta­ analysis. the methodological quality of the studies ranged from poor to moderate. Low evidence was found for the effi­ cacy of specific balance exercises, physical therapy based on an individualized problem­solving approach, and resistance and aerobic exercises on improving balance among ambula­ tory people with multiple sclerosis. Conclusion: These findings indicate small, but significant, effects of physiotherapy on balance in people with multiple sclerosis who have a mild to moderate level of disability. However, evidence for severely disabled people is lacking, and further research is needed.