Update on rehabilitation in multiple sclerosis

As mobility impairment is a hallmark of multiple sclerosis, it is probable that people with this disease will benefit from rehabilitation therapy throughout the course of their illness. The review provides an update on rehabilitation focused on balance and walking impairment. Classical rehabilitation focusing on muscle rehabilitation, neurotherapeutic facilitation is effective and recommended. Other techniques did not prove their superiority: transcutaneal neurostimulation, repetitive magnetic stimulation, electromagnetic therapy, whole body vibration and robot-assisted gait rehabilitation and need more studies to conclude. Cooling therapy, hydrotherapy, orthoses and textured insoles could represent a complementary service to other techniques in specific conditions. Multidisciplinary rehabilitation program provides positive effects and high satisfaction for patients with multiple sclerosis but needs more evaluation. New technologies using serious game and telerehabilitation seem to be an interesting technique to encourage physical activity, self-management and quality of life. Rehabilitation like other therapy requires regular clinical evaluation to adapt the program and propose appropriate techniques. What’s more, the objective of rehabilitation needs to be decided with the patient with realistic expectation.