A systematic review and meta-analysis of the effects of non-pharmacological interventions on quality of life in adults with multiple sclerosis

European Journal of Medical Research

Research

David Hodgson¹  Kasey Moss²  Victor Gitman³ 

[1] Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK;Department of Medicine, McMaster University, Hamilton, Canada;London School of Hygiene and Tropical Medicine, London, UK;

关键词: Multiple sclerosis;    Quality of life;    Non-pharmacological therapies;    Physical activity;    Behavioral interventions;    Psychological interventions;    Systematic review;    Meta-analysis;   

DOI  :  10.1186/s40001-023-01185-5

 received in 2022-06-10, accepted in 2023-06-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMultiple Sclerosis (MS) is a chronic debilitating disease that targets the central nervous system. Globally it is estimated that 2.8 million people live with MS (2018) and as there is no known cure; therefore, identifying methods to increase a patient’s quality of life (QoL) is of considerable importance. Non-pharmacological interventions are a viable and effective option to increase QoL in patients with MS, however, to date, the literature lacks a complete systematic review of these interventions.MethodsA literature search was conducted for studies published up until March 4th 2022 in Scopus, Web of Science, CINAHL Plus, The Cochrane Library, Medline, and Embase. Studies were included if they were randomized control trials (RCTs) assessing a non-pharmacological intervention in adults with MS and measured QoL using the MSQOL-54, SF-36 or MSQLI tools for at least two time points. Quality assessment of each study was completed as well as a review of publication bias. Where possible, meta-analysis was conducted using a random effects model and for other studies a qualitative synthesis was presented.ResultsThirty studies were included in the meta-analysis and eleven studies were summarized qualitatively. The pooled effects across all non-pharmacological interventions showed a modest improvement in both the physical and mental components of QoL, with a standardized mean difference (SMD) of 0.44 (95% CI 0.26–0.61) and 0.42 (95% CI 0.24–0.60), respectively. Non-pharmacological interventions based around a physical activity were found to be particularly effective in improving both the physical composite score (PCS) and mental composite score (MCS), with an SMD of 0.40 (95% CI 0.14–0.66) and 0.31 (95% CI 0.08–0.55), respectively. Interventions incorporating balance exercises presented a significant advantageous solution for improving QoL, with an SMD of 1.71 (95% CI 1.22, 2.20) and 1.63(95% CI 1.15–2.12) for PCS and MCS respectively.ConclusionsThis systematic review and meta-analysis identified that non-pharmacological interventions can be an effective method of improving QoL in patients with MS, especially modalities with a physical activity component and balance interventions.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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