Effects of Nonpharmaceutical Treatments on Symptom Management in Adults With Mild or Moderate Multiple Sclerosis: A Meta-analysis.
OBJECTIVE
The aim of this study was to conduct a meta-analysis of clinical trials on the effect of nonpharmaceutical treatments on outcomes for multiple sclerosis (MS).


METHODS
The CINAHL, Mantis, Medline, PEDro, PubMed, and Scopus databases were searched. Final papers meeting inclusion criteria were scored with the Physiotherapy Evidence Database for quality and included in a meta-analysis. Forty papers in the meta-analysis totaled 1673 participants. The interventions were grouped into 6 subcategories: physical activity, technology, rehabilitation, alternative, resistance training, and psychological.


RESULTS
The combined effect of interventions produced a large overall effect size for the outcome fatigue; medium effect sizes for functionality, balance, and quality of life; and no effect on pain or spasticity. Physical activity had the greatest effect, improving fatigue, function, and balance. Rehabilitation and resistance training had a large effect on functionality. Comparatively, psychological approaches had only a small effect on improving quality of life. Sample sizes of included papers tended to be small with large variability in design. Therefore, results should be interpreted cautiously.


CONCLUSION
Our results suggest there may be effective nonpharmaceutical treatment options available that can improve the symptoms of fatigue, poor functionality, balance, and quality of life. We found that physical activity, alternative approaches, rehabilitation, and resistance training were effective for improving the management of a number of MS symptoms.
['Byrnes|Keira Leigh|KL|', 'Whillier|Stephney|S|']
D000328:Adult D002986:Clinical Trials as Topic D015444:Exercise D005221:Fatigue D005260:Female D006801:Humans D008297:Male D009103:Multiple Sclerosis D011788:Quality of Life D055070:Resistance Training D016896:Treatment Outcome
Multiple Sclerosis Meta-analysis Complementary Therapies