Exercise-based telerehabilitation for patients with multiple sclerosis using physical activity: a systematic review.

Only two databases were searched, so relevant studies may have been missed. Only published, English-language studies were included, and the authors acknowledge that negative findings may go unreported. No pooled analysis was possible. The trials used different exercises, different outcome measures and different definitions of telerehabilitation, so the results cannot be combined or applied across settings. The samples were small, from 10 to 139 people per telerehabilitation group, and varied widely in age, disability level and type of MS. Participants were likely to be younger, more motivated and already inclined towards technology-based rehabilitation, so the results may not apply to people who are not. Only five of ten trials reported adverse events, so the safety picture rests on thin reporting. Adherence was measured in different ways across trials, so the comparisons between them are loose. The authors note that the evidence for any disease-modifying effect of exercise in MS is speculative and based on minimal evidence.

The authors declare no conflicts of interest. The text supplied does not say who funded the review.

Do not read this as proof that telerehabilitation works as well as usual care. The ten trials could not be combined because they used different exercises and outcome measures, several were small, and in two trials the control group improved as well, so the review reports what individual trials found rather than one pooled answer.