Effects of robotic rehabilitation on fatigue experience, disability, and quality of life in patients with multiple sclerosis (MS): A systematic review and meta-analysis

Abdorreza Naser Moghadasi; Mohsen Rastkar; Mehdi Mohammadifar; Aida Mohammadi; Mahsa Ghajarzadeh

doi:10.22088/cjim.15.4.589

Effects of robotic rehabilitation on fatigue experience, disability, and quality of life in patients with multiple sclerosis (MS): A systematic review and meta-analysis

Caspian J Intern Med. 2024 Aug 30;15(4):589-600. doi: 10.22088/cjim.15.4.589. eCollection 2024 Fall.

Authors

Abdorreza Naser Moghadasi¹, Mohsen Rastkar², Mehdi Mohammadifar³, Aida Mohammadi³, Mahsa Ghajarzadeh^{3

4}

Affiliations

¹ Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
² Student's Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
³ Multiple Sclerosis Research Group (MSRG), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran.
⁴ Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.

Abstract

Background: Rehabilitation plays an important role in improving symptoms in patients with multiple sclerosis (MS). There are studies evaluating the effects of robotic rehabilitation in patients with MS, but the results varied between the studies. So, we designed this systematic review and meta-analysis to estimate pooled effects of robotic rehabilitation on fatigue, disability, and quality of life in subjects with MS.

Methods: We systematically searched PubMed, Scopus, EMBASE, Web of Science, Google Scholar, and also gray literature including references of the included studies, and also conference abstracts on October 1^th 2022. Data regarding the total number of participants, first author, publication year, country of origin, mean age, EDSS, and results of fatigue and quality of life were recorded.

Results: The first literature search revealed 6878 results, after deleting duplicates, 5019 studies remained. Two researchers, evaluated the titles and abstracts, and finally 77 full texts were assessed. For meta-analysis, we included 11 studies. The pooled Standardized Mean Difference (SMD) of Kurtzke Expanded Disability Status Scale (EDSS) (after-before) estimated as -0.56 (95%CI: -0.89,-0.23). The pooled SMD of Fatigue Severity Scale (FSS) estimated as -0.54(95%CI: -1.06, -0.01) (I²=66.7%, P=0.01). The pooled SMD of physical health subscale of multiple sclerosis quality of life (MSQOL-54) estimated as 0.36(95%CI:-0.23, 0.96) (I²=51.4%, P=0.1). The pooled SMD of mental health subscale of MSQOL54 estimated as 0.48 (95%CI: 0.07, 0.88) (I²=0%, P=0.6).

Conclusions: The results of this systematic review and meta-analysis show that robotic rehabilitation has positive effects on fatigue, and disability in patients with MS.

Keywords: Multiple sclerosis; Rehabilitation; Robotic.

Publication types

Review