The effectiveness of nontraditional or home-based programing on ADL performance of individuals living with multiple sclerosis: A systematic review

Purpose: To examine evidence-based nontraditional and home-based interventions and their efficacy for use in individuals with MS to improve performance in their daily activities. Materials and methods: A search of five databases including PubMed, CINAHL, Cochrane Library, OT Seeker, and Ovid Medline produced 924 research articles. Thirty-two articles were selected for full-text review, of which 15 were included in this systematic review. Inclusion criteria: Articles were level 2B or higher evidence, had a minimum of 19 participants with MS, addressed ADLs or body functions supporting ADL performance, and were published since 2010. Exclusion criteria: Articles not written in English and not identified as nontraditional or home-based programming. Results: The review uncovered strong evidence for the use of the nontraditional interventions of vestibular rehabilitation, self-management, yoga, musical production, and ELEVIDA to improve ADL performance in individuals with MS. Strong evidence supported the use of home-based programs that included cognitive behavioral therapy, cooling suits, manual dexterity, strengthening, vestibular rehabilitation, and physical activity. Conclusions: High levels of evidence support the use of nontraditional or home-based interventions to improve ADL performance in clients with MS. Innovation and technology continue to expand the occupational therapist's toolbox of interventions.