Technology-Based Physical Rehabilitation for Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-analysis.

Abstract

To synthesize the current evidence on technology-based physical rehabilitation for balance in people with multiple sclerosis and to compare its effectiveness with that of conventional physical therapy. A comprehensive search of databases including CENTRAL Scopus, CINAHL, PsycINFO, PubMed, and PEDro was conducted up to March 2024. Studies were selected based on predefined inclusion criteria. Data extraction and quality assessment were performed independently by 2 reviewers. Statistical analyses were conducted using a random effects model. A total of 24 studies involving 985 participants were included. The meta-analysis revealed that compared with conventional physical therapy, technology-based physical rehabilitation significantly improved balance outcomes by 0.16 (95% CI, 0.04- 0.29; P=.027) with moderate heterogeneity (I²=39.1%). Subgroup analyses were performed by intervention modality (robotic assistive gait training, exergaming, and telerehabilitation), and only exergaming interventions had a medium effect on balance in this population of 0.29 (95% CI, 0.08-0.251; P=.03). Among technology-based physical rehabilitation approaches, exergaming interventions have shown promising effectiveness in improving balance in people with multiple sclerosis. Despite the moderate heterogeneity, the findings support the use of exergaming as a viable option. Further high-quality randomized controlled trials are needed to confirm these results.