Occupational therapy in adults with Multiple Sclerosis: a Cochrane systematic review

Article type
Authors
Boers A1, O'Meara C2, Eijssen I3, Bekkering G4, Koen M5, Freeman J6, Hynes S7, De Coninck L8, Kos D9
1Rehabilitation Sciences - Occupational Therapy, KU Leuven , Leuven, Belgium
2School of Nursing & Midwifery, University of Galway, Galway, Ireland
3Amsterdam UMC location Vrije Universiteit Amsterdam, Rehabilitation Medicine, MS Center Amsterdam; Research institutes Amsterdam Neuroscience, Amsterdam Movement Sciences, Amsterdam Public Health, Amsterdam, Netherlands
4Belgian Centre for Evidence-Based Medicine, Cochrane Belgium, Leuven, Belgium; Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
5MS Telefoon, MS Vereniging, Den Dolder, Netherlands
6School of Health Professions, University of Plymouth, Peninsula Allied Health Centre, Plymouth, UK
7Discipline of Occupational Therapy, School of Health Sciences, University of Galway, Galway, Ireland
8Academic Center for General Practice, KU Leuven, Leuven, Belgium
9Rehabilitation Sciences - Occupational Therapy, KU Leuven , Leuven, Belgium; Rehabilitation Research, National Multiple Sclerosis Center, Melsbroek, Belgium
Abstract
"Background: People with multiple sclerosis (PwMS) report benefits from occupational therapy (OT). With the last Cochrane systematic review conducted two decades ago, there is a critical need for updated evidence.

Aims: This Cochrane review aims to synthesize the benefits and harms of OT interventions on daily functioning, participation, and quality of life in PwMS. It also explores variations based on intervention format (individual or group) and service delivery location (outpatient, inpatient, or home-based therapy).

Methods: Standard Cochrane (OF rigorous) systematic review methods were used. Two authors independently conducted systematic searches across databases (CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, Web of Science) for controlled clinical trials of OT in PwMS. Primary outcome measures (daily functioning, quality of life, participation and adverse effects) were assessed, and risk of bias and overall quality were evaluated using Cochrane RoB2/ROBINS-I and GRADEproGDT.

Results: The electronic search yielded 12,570 articles (7,388 after de-duplication). Based on title and abstract 7,170 items were excluded, remaining 218 articles for full-text screening. Results, expected by May 2024, will be presented, encompassing a summary of findings table, potential meta-analysis results in a forest plot, and insights into health equity considerations.

Discussion: The review findings are expected to benefit people with MS by influencing the evidence-based decisions of occupational therapists, policymakers, and healthcare organizations. They will inform guideline development, and aid researchers by pinpointing knowledge gaps. 

Funding: Elizabeth Casson Trust, UK; Evidence Synthesis Ireland, Ireland
"