OBJECTIVE: To assess the efficacy of physiotherapy interventions, including exercise therapy, for the rehabilitation of people with progressive multiple sclerosis. DATA SOURCES: Five databases (Cochrane Library, Physiotherapy Evidence Database (PEDro), Web of Science Core Collections, Medline, Embase) and reference lists of relevant articles were searched. STUDY SELECTION: Randomised experimental trials which included participants with progressive multiple sclerosis and investigated a physiotherapy intervention or an intervention containing a physiotherapy element were included. DATA EXTRACTION: Data were independently extracted using a standardised form and methodological quality was assessed using the PEDro scale. DATA SYNTHESIS: Thirteen studies (described by 15 articles) were identified; scoring between 5 and 9 out of 10 on the PEDro scale. Eight interventions were assessed: exercise therapy, multi-disciplinary rehabilitation, functional electrical stimulation, botulinum toxin type A injections and manual stretches, inspiratory muscle training, therapeutic standing, acupuncture and body weight supported treadmill training. All studies, apart from one, produced positive results in at least one outcome measure, however, only one article used a power calculation to determine their sample size and due to 'drop outs' the results were subsequently underpowered. CONCLUSIONS: This review suggests that physiotherapy may be effective for the rehabilitation of people with progressive multiple sclerosis. However, further appropriately powered studies are required.

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