OBJECTIVES: Multiple sclerosis (MS) is a demyelinating, degenerative disease of the central nervous system. It is a progressive disease that can lead to severe disability, functional limitations and a poor quality of life (QoL). People with multiple sclerosis (PwMS) may live for many years with severe mobility problems and may require regular therapeutic intervention. The objective of this review is to assess current published literature evaluating all types of interventions for PwMS with an expanded disability status scale (EDSS) score >= 6. METHODS: A search of eight databases was conducted using relevant search terms. Articles were included if a therapeutic intervention was evaluated in PwMS with an EDSS score of >= 6 or if some or all of the participants used a walking aid. RESULTS: Twelve studies fulfilled the criteria for this review. The interventions evaluated in these studies included a range of physiotherapy treatments, for example, balance rehabilitation, resistance exercise, aerobic exercise and others. DISCUSSION: The evidence from this review suggests that all of the interventions described can potentially be beneficial for PwMS. As studies have not taken mobility levels into account the optimal type of intervention and its frequency and duration for this population is unknown and further research is needed to develop treatment recommendations for clinicians treating PwMS with moderate to severe mobility problems.

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A brief summary and a critical assessment of this review may be available at DARE