Academic Journal
Effectiveness of vestibular rehabilitation in patients with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials.
| Title: | Effectiveness of vestibular rehabilitation in patients with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials. |
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| Authors: | Peng HH; Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan., Nhu NT; Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam., Hou WH; Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan. houwh@tmu.edu.tw.; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Xinyi Dist, Taipei Medical University, No. 250, Wuxing St, 110017, Taipei, Taiwan. houwh@tmu.edu.tw.; School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan. houwh@tmu.edu.tw.; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. houwh@tmu.edu.tw.; Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan. houwh@tmu.edu.tw. |
| Source: | Journal of neurology [J Neurol] 2026 Aug 27; Vol. 273 (9). Date of Electronic Publication: 2026 Aug 27. |
| Publication Type: | Journal Article; Systematic Review; Meta-Analysis |
| Language: | English |
| Journal Info: | Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 0423161 Publication Model: Electronic Cited Medium: Internet ISSN: 1432-1459 (Electronic) Linking ISSN: 03405354 NLM ISO Abbreviation: J Neurol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Berlin ; New York, Springer-Verlag |
| MeSH Terms: | Multiple Sclerosis*/rehabilitation , Multiple Sclerosis*/complications , Vestibular Diseases*/rehabilitation , Vestibular Diseases*/etiology , Outcome Assessment, Health Care*/statistics & numerical data , Neurological Rehabilitation*, Postural Balance/physiology ; Dizziness/rehabilitation ; Dizziness/etiology ; Humans ; Randomized Controlled Trials as Topic |
| Abstract: | Background: Patients with multiple sclerosis (MS) frequently experience postural instability, dizziness, and impaired eye-head-body coordination, which reduce mobility and quality of life (QoL). Vestibular rehabilitation (VR) may improve vestibulo-ocular and vestibulo-spinal function. Objectives: To evaluate the effects of VR on balance, gait function, transfer ability, dizziness, fatigue, depression, and QoL in patients with MS. Methods: PubMed, EMBASE, the Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from inception to May 2026. Eligible randomized controlled trials (RCTs) compared VR with traditional physiotherapy, usual care, or no intervention. Random-effects meta-analyses were performed using Review Manager 5.4.1. Results: Thirteen RCTs involving 454 patients with MS were included. Compared with the control interventions, VR significantly improved balance (standardized mean difference [SMD]: 1.24, 95% confidence interval [CI] 0.46-2.01), walking speed (MD: 0.19, 95% CI 0.12-0.26), walking endurance (SMD: 0.43, 95% CI 0.08-0.78), dizziness (MD -10.56, 95% CI -18.42 to -2.71), fatigue (SMD: -1.23, 95% CI -2.25 to -0.21), and depression (MD -4.14, 95% CI -7.16 to -1.12). No significant between-group differences were observed in transfer ability (SMD: -0.58, 95% CI -1.22 to 0.06), balance self-efficacy (MD 14.58, 95% CI -2.92 to 32.09), or QoL (SMD 0.51, 95% CI-0.45 to 1.48). Conclusions: VR may improve balance, walking speed, walking endurance, dizziness, fatigue, and depression in patients with MS; however, the certainty of evidence is generally low or very low. Therefore, larger RCTs are required. (© 2026. Springer-Verlag GmbH Germany, part of Springer Nature.) |
| Competing Interests: | Declarations. Conflicts of interest: The authors declare that they have no conflicts of interest. Ethical approval: Not applicable; this study is a review and meta-analysis of the literature. Patient consent: This article does not contain any studies with human participants performed by any of the authors. |
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| Contributed Indexing: | Keywords: Balance; Dizziness; Gait; Multiple sclerosis; Systematic Review and Meta-analysis; Vestibular rehabilitation |
| Entry Date(s): | Date Created: 20260827 Date Completed: 20260827 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| DOI: | 10.1007/s00415-026-14082-8 |
| PMID: | 42658257 |
| Database: | MEDLINE |
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