Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 26064
  Title Effects of nonpharmaceutical treatments on symptom management in adults with mild or moderate multiple sclerosis: A meta-analysis
Journal J Manipulative Physiol Ther. 2019 Sep;42(7):514-531
Peer Review Yes
Publication Type Article

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.

Author keywords: Meta-analysis, Multiple Sclerosis, Complementary Therapies

Author affiliations: Chiropractic Department, Macquarie University, Sydney, NSW, Australia

This abstract is reproduced with the permission of the publisher; full text is available by subscription. Click on the above link and select a publisher from PubMed's LinkOut feature.


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