The Effectiveness of Physiotherapy Interventions for Mobility in Severe Multiple Sclerosis: A Systematic Review and Meta-Analysis

Table 5

Vote counting of studies for severe MS patients, not included in the meta-analysis.

Study characteristics			Intervention			Outcomes	Vote counting
Studies		PT intervention	Disability scale	Duration (weeks)	Frequency (X/week)	Outcomes post intervention	Significant mobility-related outcomes
Williams et al. [44]	26	Community group exercise	3-5 disease step rating scale	8 weeks	2/week
Chotiyarnwong et al. [38]	10	BFR	6.0-7.0	1 session	1 day	↑ 6MWT, ↑ waking speed, ↓ perceived exertion	None
Daniele Munaria et al. [42]	5	RAGT+VR		6 weeks	2/week	↑ 2MWT, ↓ 10 MW, ↑ BBS, ↑ cognitive function, ↓ double support time, ↓ sway area	None
Manfredini et al. [41]	23	RAGT	6.0-7.0	6 weeks	2/week	↑ 6MWT, improve mitochondrial function biomarker, ↑ rmVO2	↑6MWT
	23	CWT	6.0-7.0		2/week	, improve mitochondrial function biomarker,	↑6MWT
Lamberti et al. [40]	12	BFR-W		6 weeks	2/week	, , , , , ,	, ,
Willingham et al. [35]	6	BWST+antigravity treadmill training	6.0-6.5	8 weeks	2/week	, ,	None
Jonsdottir et al. [32]	8	BWST if needed dual task training		4 weeks	5/week	↑ 2MWT,↓ 10WMT, ↑ balance, ↑ DGI,↓ TUG	↑2MWT
	2	Resistance ex.		4 weeks	5/week	↑ 2MWT, ↓ 10WMT, ↑ balance, ↑ DGI, ↓ TUG	None
Martini et al. [33]	20	ADSTEP	(history of fall)	6 weeks	1/week	, , , , , ,	None
Pompa et al. [31]	25	CWT	6.0–7.5	4 weeks	3/week	, , , , ,	RMI
Pilutti et al. [28]	5	TBRST	6.0-8.0	12 weeks	3/week	↓ fatigue, ↑ QoL, ↔ T25FW	None
Robinson et al. [27]	20	(Exergaming) Nintendo Wii fit	6.00	4 weeks	2/week	↑ balance, ↓ MSWS-12, ↓ postural sway, ↑ step length, ↑ stride length	None
	18	Balance training		4 weeks	2/week	↑ balance, ↓ MSWS-12, ↓ postural sway, ↑ step length, ↑ stride length	None
Hogan et al. [26]	66	Group physio-therapy	3–4 mobility section of (GNDS)	10 weeks	1/week	, , , ,
	45	1 : 1 physiotherapy		10 weeks	1/week	, , , , ,	↑balance , ↓mFIS, ↑6MWT
	16	Yoga		10 weeks	1/week	, ,	↑balance
Jackson et al. [21]	4	Kickboxing	6.0-6.5	5 weeks	3/week	↑ balance, gait speed, ↑ Mini-BESTest, ↓ TUG	None
Miller et al. [19]	15	Home ex	6.5–8	8 weeks	2/week	↓ 10WMT, ↓ FIM, ↓ EDSS, ↑ MSIS 29, ↑ muscle strength, ↓ timed sit-stand	None
Giesser et al. [13]	4	BWST	7.0-8.0	20 week	2/week	↓ 10WMT, ↑ 6MWT, ↑ balance, ↑ muscle strength, ↑ QoL, ↓ spasticity (not all patients were able to complete the 10WMT, 6MWT)	None

2MWT: 2 minutes walking test; 5TST: 5-time sit to stand; 6 MWT: 6 min walk test; 10WMT: Ten-Meter Walking Test; ADSTEP: Assistive Device Selection Training and Education Program; BBS: Berg Balance Scale; BFR-W: Blood Flow-Restricted Slow Walking; BWST: Body weight supported training; DGI: dynamic gait index; DST: double support time; EBI: Extended Barthel Index; EDSS: Expanded Disability Status Scale; FAC: Functional Ambulation Category; FSS: Fatigue Severity score; FES: functional electrical stimulation; FSST: Four Square Step Test; FIM: Functional Independence Measure; GNDS: The Guy’s Neurological Disability Scale; MAS: Modified Ashworth Scale; mBI: modified Barthel Index; mFIS: modified Fatigue Impact Scale; Mini-BESTest: mini Balance Evaluation System Test: MSIS-29: multiple sclerosis impact scale; MSWS: Multiple Sclerosis Walking Scale questionnaire; ODFS: Odstock dropped foot stimulator; PHQ: patient health questionnaire; QoL: quality of life; RAGT: Robot-Assisted Gait Training; RAGT-VR: Robot-Assisted Gait Training combined with Virtual Reality; rmVO2: resting muscle oxygen consumption; RMI: Rivermead Mobility Index; ROM: Range of motion; SLR: Step Length ratio; TBRST: Total-Body Recumbent Stepper Training; T25FW: timed 25-foot walk test; TST: timed stair test; TUG: Timed Up and Go; VAS: Visual Analogue Scale.; VO2peak: peak oxygen consumption; NR: not reported. Abbreviations are presented in an alphabetical order. Statistically significant at or .