Clinical Rehabilitation最新文献

{"title":"Reliability and validity of the Upper Limb Performance Assessment for functional prehension tasks in adults with stroke: A prospective study.","authors":"Julie Lacombe, Solène Piagno, Benoit Lepage, Margot Morin, Judy Ranka, Camille Cormier, David Gasq, Claire Villepinte","doi":"10.1177/02692155261474839","DOIUrl":"https://doi.org/10.1177/02692155261474839","url":null,"abstract":"<p><p>BackgroundManaging upper limb motor performance in daily living is a challenge for adults with stroke. Current assessments demonstrate limitations for evaluation of personalised activity performance in real environments.ObjectiveTo examine the reliability, validity, clinical utility and interpretability of a standardised ecologically task-based assessment of upper limb motor performance in post-stroke adults using the Upper Limb Performance Assessment.DesignA prospective validation study.SettingA neurorehabilitation centre.Participants100 adults with chronic post-stroke upper limb deficit. Performance was rated by three trained occupational therapists.Main measuresUpper limb movement was analysed through Upper Limb Performance Assessment on a video-recorded prehension drinking task. Prehension was rated for reliability and measurement error with the intra-class correlation coefficient and the minimal difference. Validity was examined with the Fugl-Meyer Assessment for Upper Extremity, the Wolf Motor Function Test, the Motor Activity Log and the Functional Independence Measure according to Spearman's rank correlation coefficient.ResultsReliability demonstrated adequate reliability metrics (intra-class correlation coefficient: 0.87-0.97) and measurement error (12.56%-15.99%) without systematic bias. Convergent validity was strong with the Fugl-Meyer Assessment (Spearman's rank correlation coefficient (ρ)= .76, <i>p</i> < .01), Wolf Motor Function Test (ρ= .72, <i>p</i> < .01), Motor Activity Log (ρ=.67, <i>p</i> < .05) and Functional Independence Measure (ρ=.58, <i>p</i> < .01). Clinical utility for administration time and costs was demonstrated.ConclusionThe Upper Limb Performance Assessment demonstrated excellent reliability among trained raters, adequate convergent validity and interpretability in adults with stroke, demonstrating moderate clinical utility. It presents an interest as an observer-rated performance-based measure of functional prehension in real-life settings.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261474839"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biofeedback in Parkinson's disease: A systematic review with meta-analysis.","authors":"Arielle Baumgart, Elisabeth Preston, Louise Ada, Maria Tereza M Alvarenga, Juliana Fb de Mondença, Allyson Flynn","doi":"10.1177/02692155261474067","DOIUrl":"https://doi.org/10.1177/02692155261474067","url":null,"abstract":"<p><p>ObjectivesThe objective was to examine whether the addition of biofeedback to practice is effective in improving lower limb activity compared with practice alone for people with Parkinson's disease.Data sourcesFour databases were searched for randomised trials of adults with idiopathic Parkinson's disease. Trials included biofeedback delivered concurrently during practice of sitting, standing up, standing and/or walking compared with the same amount of practice without biofeedback. Outcomes were measures of activity congruent with the activity trained, such as Berg Balance Scale, Timed Up and Go test, and walking speed.Review methodSystematic review with meta-analyses of randomised trials following PRISMA guidelines, using the PEDro scale for risk of bias and GRADE to determine quality of evidence.ResultsTwenty trials were included, involving 814 participants. Biofeedback during the practice of sitting and standing increased Berg Balance Scale score by 1.5 out of 56 (95% CI 0.7 to 2.3), biofeedback during the practice of standing and walking decreased Timed Up and Go time by 0.2 s (95% CI -1.4 to 1.8), and biofeedback during the practice of walking increased walking speed by 0.02 m/s (95% CI -0.06 to 0.1). The quality of the evidence was high for balance, moderate for mobility, and low for walking.ConclusionThis systematic review provides evidence that the addition of biofeedback to the practice of lower limb activities is no more effective than practice alone in people with Parkinson's disease.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261474067"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive validity and clinical relevance of DriveSafe DriveAware as a cognitive assessment of fitness to drive in medically at-risk drivers.","authors":"Belinda Joy Johnston, Joan Margaret O'Donnell, Vanita Parekh, Jacqueline Wesson, Lynette Mackenzie","doi":"10.1177/02692155261471411","DOIUrl":"https://doi.org/10.1177/02692155261471411","url":null,"abstract":"<p><p>ObjectiveTo evaluate the predictive validity and potential clinical relevance of the DriveSafe DriveAware assessment for predicting on-road driving outcomes in medically at-risk drivers.DesignProspective cohort study.SettingFitness-to-drive assessment pathway involving a driver licensing authority, medical review clinic, and occupational therapy driver assessors in the Australian Capital Territory, Australia.ParticipantsA convenience sample of 138 drivers referred for occupational therapy driving assessment because of medical fitness-to-drive concerns.MethodsParticipants completed the DriveSafe DriveAware, comprising DriveSafe and DriveAware subtests, before an on-road driving assessment. On-road outcomes were dichotomised as pass (unrestricted licence) or fail (conditional licence, reassessment, or licence cancellation). Receiver operating characteristic analyses, Youden's Index, and classification accuracy metrics were calculated.ResultsDriveSafe DriveAware demonstrated strong classification performance, with 86% sensitivity, 100% specificity, 100% positive predictive value, and 93% overall accuracy. Eighty-seven percent of participants were classified as <i>Likely to Pass</i> or <i>Likely to Fail</i>, with 13% classified as <i>Further Testing</i>. No participants classified as <i>Further Testing</i> achieved an unconditional pass. DriveSafe and DriveAware subtests showed excellent discrimination (area under the curve = 0.96 and 0.95, respectively). Optimal cut-offs were broadly consistent with previously proposed thresholds. Drivers who failed the on-road assessment were older and had lower DriveSafe and DriveAware subtest scores than those who passed.ConclusionDriveSafe DriveAware showed strong predictive validity in this sample and may support triage and clinical decision-making within fitness-to-drive assessment pathways.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261471411"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards global standards in stroke rehabilitation and recovery: An international evaluation of practice alignment.","authors":"Thoshenthri Kandasamy, Rachel C Stockley, Jeroen M Hendriks, Shamala Thilarajah, Noorazah Azah Abd Aziz, Erin Godecke, Jie Jia, Margit Alt Murphy, Elizabeth A Lynch","doi":"10.1177/02692155261478023","DOIUrl":"https://doi.org/10.1177/02692155261478023","url":null,"abstract":"<p><p>ObjectiveTo evaluate how Centres of Clinical Excellence criteria align with routine clinical practice in international stroke rehabilitation centres and explore the factors influencing practices across diverse health systems.DesignMixed-methods study.SettingInternational stroke rehabilitation centres across diverse geographic and economic contexts.ParticipantsClinicians and service leaders representing 15 centres from 10 countries (two lower-middle-income, two upper-middle-income, and six high-income).InterventionEvaluation of how international stroke rehabilitation centres demonstrate performance that aligns with the multidimensional Centre of Clinical Excellence criteria, and exploration of the contextual factors influencing practices across diverse health systems.Main measuresSurvey responses and semi-structured interview data examining patient-centred care, interprofessional practice, workforce development, research, mentorship and organisational structures supporting clinical excellence.ResultsStrong alignment was observed for patient-centred outcomes, interprofessional teamwork, and staff education, supported by established clinical pathways and outcome measurement processes. High-income and metropolitan centres more frequently reported protected time, funding, and formal workforce development structures. Centres in low- and middle-income and regional settings relied more on informal processes due to resource constraints. Across all contexts, leadership development, mentorship, advocacy, research engagement, and continuity of care were inconsistently implemented and documented.ConclusionsCore domains of stroke rehabilitation are well established internationally; however, system-level supports that sustain evidence-based practice vary considerably. Embedding structured leadership, workforce development, research engagement, and advocacy mechanisms alongside routine care may strengthen sustainability, improve consistency of evidence-based practice, and reduce inequities in rehabilitation outcomes.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261478023"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and external validation of quality indicators for Neurorehabilitation Units: The REHABest Delphi study.","authors":"Jacobo Formigo-Couceiro, Clara Pérez-Esteve, José María Climent-Barberá, Carlos Cordero-García, Raquel Cutillas-Ruiz, Esther Duarte, Francisco Javier Juan-García, María Lourdes López De Munaín, Rosa Martín-Mourelle, Antonio Montoto-Marqués, Serafín Rodríguez-Palero, Pedro Ignacio Tejada-Ezquerro, Emilio Ignacio-García, Helena Bascuñana-Ambrós","doi":"10.1177/02692155261470080","DOIUrl":"https://doi.org/10.1177/02692155261470080","url":null,"abstract":"<p><p>ObjectiveTo develop a consensus-based framework of quality indicators for Neurorehabilitation Units.DesignDelphi consensus study with two-phase external validation.SettingExpert consultation and external validation were conducted through online questionnaires.ParticipantsTwelve neurorehabilitation experts participated in the Delphi process. External validation involved 63 independent specialists and a multidisciplinary panel of nine professionals.InterventionDevelopment of quality indicators through a three-round Delphi process following Conducting and REporting DElphi Studies (CREDES) recommendations.Main measuresExpert agreement on candidate indicators, with consensus defined a priori as ≥75%.ResultsAn initial qualitative expert-generation phase produced 38 candidate indicators. These were subsequently refined through three Delphi rounds, during which indicators were retained, merged, reformulated, added, or disaggregated according to expert consensus and accreditation level. The final framework comprised 50 indicators categorized into structure (21), process (13), and outcome (16) domains. External validation confirmed the relevance and clarity of the framework, although implementation challenges were identified in centres with heterogeneous resources.ConclusionsThe proposed framework provides a structured set of quality indicators that may support quality assessment, accreditation, and continuous improvement in neurorehabilitation services.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261470080"},"PeriodicalIF":2.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of early neuroimaging and neurophysiological biomarkers for post-stroke mobility prognostication.","authors":"Cristina Levy, Emily J Dalton, Jennifer K Ferris, Bruce Cv Campbell, Amy Brodtmann, Sandra Brauer, Leonid Churilov, Kathryn S Hayward","doi":"10.1177/02692155261467649","DOIUrl":"https://doi.org/10.1177/02692155261467649","url":null,"abstract":"<p><p>ObjectivePrognostication may help guide mobility rehabilitation planning and goal setting post-stroke. This systematic review aimed to examine the prognostic capacity of early neuroimaging and neurophysiological biomarkers of mobility outcomes up to 24 months post-stroke.Data sourcesMEDLINE/EMBASE was searched from inception to May 2026. Cohort studies that reported neuroimaging or neurophysiological biomarkers measured <14 days post-stroke and mobility outcome(s) assessed >14 days but ≤24 months post-stroke were included.Review methodsBiomarker analyses were classified by statistical analysis approach (association, discrimination/classification, validation). Magnitude of relevant statistical measures was the primary indicator of prognostic capacity. Risk of bias was assessed using the Quality in Prognostic Studies tool.ResultsTwenty-six reports from 23 independent study samples (n = 2678 participants) were included. Biomarkers were measured a median of 9.3 days post-stroke, and outcomes were assessed between 1 and 24 months. One hundred and nine biomarker analyses were identified (84 neuroimaging, 25 neurophysiological). Most analyses were association (88%), and few were discrimination/classification (10%) and validation (2%). Structural and functional corticospinal tract integrity metrics were frequently investigated, but findings were mostly small or non-significant. Lesion location and size findings were also commonly examined, but findings were inconsistent. Common methodological limitations included small sample sizes, moderate to high risk of bias, poor magnitude reporting and heterogeneous outcomes and follow-up timepoints.ConclusionCurrent evidence is insufficient to support the use of early neuroimaging and neurophysiological biomarkers for post-stroke mobility prognostication. International collaboration using harmonised methodologies, standardised statistical reporting and consistent outcome measures and timepoints is needed to generate meaningful prognostic information to guide rehabilitation.RegistrationCRD42022350771.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261467649"},"PeriodicalIF":2.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple-adverse health conditions, mental health, and health-related quality of life in stroke survivors: Latent profile analysis and mediation analysis.","authors":"Yuyang Zhang, Yulu Wang, Yujiao Hao, Yang Li, Bingxin Ma, Jin Yang, Jiali Zheng, Xiaojun Zhang, Yaogang Wang, Mei Lin, Yue Zhao, Qi Lu","doi":"10.1177/02692155261478022","DOIUrl":"10.1177/02692155261478022","url":null,"abstract":"<p><p>ObjectiveThis study aimed to identify subgroups of stroke survivors based on multiple-adverse health conditions and determine the potential mediation effects of mental health in their relationship with health-related quality of life.DesignA cross-sectional study.SettingThree tertiary hospitals in Tianjin, China.ParticipantsA total of 558 stroke survivors were recruited between March and June 2023.Main measuresMultiple-adverse health conditions (multimorbidity, frailty and disability) were assessed using the age-corrected Charlson Comorbidity Index, FRAIL Scale, and Barthel Index. Mental health was measured with Patient Health Questionnaire-4, and health-related quality of life was evaluated using the EuroQol 5-dimension 5-level scale. Latent profile analysis identified subgroups, and mediation analysis explored mental health's role.ResultsThree subgroups were identified: Mild (65.4%, <i>n = </i>365), Moderate (17.4%, <i>n = </i>97), and Severe (17.2%, <i>n = </i>96). Mediation analysis showed that, compared with the Mild subgroup, survivors in the Moderate subgroup (<i>β</i> = 0.138, 95% CI: 0.055 to 0.232) and the Severe subgroup (<i>β</i> = 0.217, 95% CI: 0.113 to 0.316) exhibited worse mental health, and poorer mental health was associated with lower health-related quality of life (<i>β</i> = -0.119, 95% CI: -0.170 to -0.075).ConclusionsThis study suggests heterogeneity in multiple-adverse health conditions and indicates that mental health may partially account for the association between these conditions and health-related quality of life in stroke survivors. The findings highlight the need for further research into subgroup-specific interventions-with particular attention to mental health-to determine whether such approaches could improve health-related quality of life.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261478022"},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of the breakfast group intervention BISTRo for stroke survivors in acute rehabilitation.","authors":"Natalie Jones, Susan Mawson, Avril Drummond, Alicia O'Cathain","doi":"10.1177/02692155261476634","DOIUrl":"10.1177/02692155261476634","url":null,"abstract":"<p><p>ObjectiveTo examine the feasibility and acceptability of a co-designed breakfast group intervention, BISTRo, delivered within an acute stroke rehabilitation service.DesignMultisite mixed-methods feasibility study.SettingThree National Health Service stroke rehabilitation wards in the United Kingdom.ParticipantsSixteen stroke survivors and 53 multidisciplinary staff from occupational therapy, physiotherapy, speech and language therapy, dietetics, nursing, and psychology.InterventionA structured breakfast group, delivered on five mornings a week over two weeks, integrating social dining, peer support, multidisciplinary rehabilitation, and functional eating and drinking practice.MethodsAttendance, attrition, and therapy dose were recorded. Patient-reported outcomes included a self-confidence Likert scale and subscales of the Confidence after Stroke Measure. Semi-structured interviews with stroke survivors and staff focus groups explored acceptability. Qualitative data were analysed thematically using feasibility and acceptability frameworks.ResultsSixteen stroke survivors participated across all wards, with high attendance (mean 8.9 sessions/standard deviation 1.45 out of 10), no intervention-related withdrawals, and complete data collection. Fifteen participants improved on the self-confidence measure. Positive attitude scores improved in eight participants, remained stable in five, and declined in three. In interviews with stroke survivors (<i>n</i> = 12) and focus groups with staff (<i>n</i> = 21), BISTRo was described as meaningful, confidence-building, and socially supportive. Staff also reported improved interdisciplinary working and manageable resource demands.ConclusionsDelivery of the BISTRo breakfast group was feasible and acceptable and warrants further evaluation. Conducting this feasibility study has enabled identification of potential changes to the trial design.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261476634"},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue after ischaemic stroke: A five-year longitudinal study of prevalence and latent trajectory subgroups.","authors":"Kristin Haugskott Tiller, Hild Fjærtoft, Siw Tone Innstrand, Stian Lydersen, Heather Allore, Geske Luzum, Fredrik Ildstad, Bent Indredavik","doi":"10.1177/02692155261476638","DOIUrl":"10.1177/02692155261476638","url":null,"abstract":"<p><p>ObjectiveTo investigate the prevalence and longitudinal course of post-stroke fatigue and identify subgroups with distinct fatigue trajectories up to 5 years post-stroke.DesignA prospective, longitudinal, multi-centre cohort study.SettingHospital stroke units in the Central-Norway health region.ParticipantsIncident ischaemic stroke patients were recruited during acute hospitalisation between June 2015 and November 2017. Data were collected during the hospital stay and at 3 months, 1 year, 3 years, and 5 years.Main measuresFatigue was assessed using the 7-item Fatigue Severity Scale with <u>></u>5 as cut-off to define clinical fatigue.ResultsA total of 693 participants were included. The prevalence of clinical fatigue was 24% (3 months), 28% (1 year), 30% (3 years), and 28% (5 years). A Sankey diagram illustrated substantial variability in fatigue status across time points. Using group-based trajectory modelling, four latent subgroups with distinct fatigue trajectories were identified: (1) low fatigue, (2) emerging fatigue, (3) improving fatigue, and (4) high fatigue.ConclusionOne quarter to one third of the study population consistently exhibited fatigue up to 5 years post-stroke. High variability in fatigue status over time was evident, indicating individual-level heterogeneity in the longitudinal course. This was further confirmed by the identification of four latent subgroups with distinct post-stroke fatigue trajectories. Early detection of individuals at risk of an adverse fatigue trajectory and differentiated follow-up may improve outcomes for stroke survivors.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261476638"},"PeriodicalIF":2.9,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical and mental health-related quality of life outcomes of non-pharmacological interventions in early multiple sclerosis: A systematic review and meta-analysis.","authors":"Adam Dawidziuk, Delfina Popiel","doi":"10.1177/02692155261474089","DOIUrl":"10.1177/02692155261474089","url":null,"abstract":"<p><p>ObjectiveTo determine the effect of non-pharmacological interventions on physical and mental health-related quality of life among adults with early diagnosed multiple sclerosis.Data sourcesPubMed, EMBASE, Cochrane CENTRAL, ClinicalTrials.gov and APA PsycINFO were searched from database inception to 8 July 2026.Review methodsWe conducted a systematic review and meta-analysis of randomised controlled trials comparing non-pharmacological interventions with control conditions in adults with early-stage multiple sclerosis and minimal disability. Outcomes were physical and mental health-related quality of life after treatment and at follow-up. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Effects were pooled using standardised mean differences.ResultsEleven randomised controlled trials including 696 participants were included. The updated search identified no additional eligible trials. Interventions included exercise, physiotherapy, balance training, cognitive rehabilitation and behavioural therapies. After treatment, interventions produced a small improvement in physical health-related quality of life, with a standardised mean difference of 0.28 and a 95% confidence interval from 0.11 to 0.46. The effect on mental health-related quality of life was smaller and uncertain, with a standardised mean difference of 0.16 and a 95% confidence interval from -0.04 to 0.35. Follow-up effects were not clearly sustained.ConclusionNon-pharmacological interventions may provide modest short-term physical health-related quality-of-life benefits. Effects on mental health-related quality of life and digitally delivered rehabilitation remain uncertain.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261474089"},"PeriodicalIF":2.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}