Cognitive rehabilitation on gait and balance in patients with multiple sclerosis: a systematic review and meta-analysis

Hendawy, Ahmed Abdelhamied; SAWAN, SALAH ABDEL MONEIM; Elserougy, Hager Rasmy

doi:10.21608/bijpt.2025.362739.1065

Cognitive rehabilitation on gait and balance in patients with multiple sclerosis: a systematic review and meta-analysis

Document Type : Original Article

Authors

¹ Department of Physical Therapy for Diseases and Surgeries of The Neuromuscular System, Faculty of Physical Therapy, Galala University.

² Professor of Physical Therapy for Neurology Faculty of Physical Therapy, Cairo University

³ Physical Therapy for Diseases and Surgeries of the Neuromuscular System, College of Physical Therapy, Misr University for Science and Technology, Giza, Egypt.

10.21608/bijpt.2025.362739.1065

Abstract

Background: Cognitive impairment is a common symptom of multiple sclerosis (MS) and often affects patients' motor functions, particularly gait and balance. Purposes: This systematic review aimed to assess the impact of cognitive rehabilitation on gait and balance in patients with MS . Methods: A systematic search was conducted across five databases: PubMed, the Cochrane Library, Web of Science, Scopus, and PEDro. Randomized controlled trials (RCTs) investigating the effects of cognitive rehabilitation on gait and balance in adult MS patients were included. The primary outcomes included balance and gait parameters, whereas the secondary outcomes included mobility and patient reported outcomes. Studies were appraised for methodological quality via the PEDro scale. Results: A total of 16 RCTs involving 1,173 participants were included. Despite various cognitive training approaches, no significant improvements were observed in balance control, postural sway, or gait. However, dual-task training increased mobility, as measured by the timed up and go (TUG) test. Patient-reported outcomes, such as the Multiple Sclerosis Walking Scale-12 (MSWS-12), did not significantly improve. The heterogeneity in intervention types and outcome measures across studies may have influenced these findings. Conclusions: Cognitive training appears to improve specific mobility parameters in MS patients but does not significantly affect balance. These findings suggest that integrating cognitive training with traditional physical therapies may optimize rehabilitation outcomes. Future research should focus on standardized interventions and longer follow-up periods. Additionally, considering the diverse impacts of MS on individuals, personalized approaches to cognitive training could be beneficial in clinical settings.

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