Abstract

Importance: Evidence supports interventions for work and social participation for adults with multiple sclerosis (MS).

Objective: To systematically collect and evaluate the evidence for the effectiveness of interventions within the scope of occupational therapy practice to improve or maintain the performance of and participation in education, work, volunteering, leisure, and social participation among adults with MS.

Data Sources: MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane Database of Systematic Reviews searches for articles published from January 2011 to December 2018.

Study Selection and Data Collection: Two independent reviewers analyzed articles using Cochrane methodology. Articles were assessed in terms of inclusion and exclusion criteria, quality, and risk of bias.

Findings: Although the review was developed to address education, work, volunteering, leisure, and social participation, only work and social participation outcomes were found in the literature. Six hundred eighteen articles were reviewed, and 4 articles met the inclusion criteria. One Level 1b study and 1 Level 3b study provided moderate strength of evidence with moderate risk of bias for an online work intervention to improve self-esteem and better understand career goals. One Level 3b study provided low strength of evidence for interdisciplinary rehabilitation to address work. Finally, 1 Level 1b study with a yoga group intervention provided moderate strength of evidence with low risk of bias to improve social participation.

Conclusions and Relevance: This review highlights the lack of evidence related to various types of participation for adults with MS. The evidence focused on work and social participation was limited.

What This Article Adds: This review highlights the need for interventions within the scope of occupational therapy for increased participation for adults with MS.

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