Date Presented 04/02/2022

This review provides evidence of nontraditional and alternative interventions to inspire practitioners to implement practices outside traditional rehabilitation. This review empowers clinicians to explore home-based and nontraditional interventions to improve the activities of daily living performance of persons living with multiple sclerosis. Clinicians will strengthen their foundational knowledge to incorporate alternative interventions to advance their practice.

Primary Author and Speaker: Shelby Rogers

Additional Authors and Speakers: Alexandra Lambropoulos

Contributing Authors: Amanda Hajare, Kimberlyn Belveal, Claudia List Hilton, Amber B. Armstead, Stephanie Gunkel

PURPOSE: Multiple Sclerosis is a neurodegenerative disease that affects individuals’ abilities to participate in activities of daily living. Evidence shows that nontraditional and home-based programs are effective means of improving activities of daily living performance of persons living with multiple sclerosis. This systematic review examines evidence-based nontraditional and home-based interventions and their efficacy for use in persons living with multiple sclerosis to improve performance in their daily activities.

DESIGN: 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, and 15 were included in this systematic review.

METHOD: Inclusion criteria: Articles were level 2B or higher evidence, had a minimum of 25 participants with multiple sclerosis, addressed activities of daily living or body functions supporting activities of daily living performance, and were published since 2010. Exclusion criteria: Articles not written in English, not peer-reviewed, and articles published prior to 2010 were excluded.

RESULTS: The review uncovered strong evidence supporting nontraditional interventions of vestibular rehabilitation, self-management, yoga, musical production and ELEVIDA to improve activities of daily living performance in individuals with multiple sclerosis. Strong evidence supported home-based programs including cognitive behavioral therapy, cooling suits, manual dexterity, strengthening, vestibular rehabilitation and physical activity programs.

CONCLUSION AND RELEVANCE: High levels of evidence support nontraditional and/or home-based interventions to improve activities of daily living performance in persons living with multiple sclerosis. Innovation and technology continue to expand the occupational therapists’ toolbox of interventions.

OCCUPATIONAL THERAPY IMPLICATIONS: This review provides occupational therapy practitioners with evidence that supports the use of nontraditional and home-based treatments for addressing activities of daily living performance in persons living with multiple sclerosis.


Bass, A. D., Van Wijmeersch, B., Mayer, L., Mäurer, M., Boster, A., Mandel, M., Mitchell, C., Sharrock, K., & Singer, B. (2020). Effect of multiple sclerosis on daily activities, emotional well-being, and relationships: The global vsMS survey. International Journal of MS Care, 22(4), 158-164.

Conradsson, D., Ytterberg, C., Engelkes, C., Johansson, S., & Gottberg, K. (2019). Activity limitations and participation restrictions in people with multiple sclerosis: a detailed 10-year perspective. Disability and Rehabilitation, 1-8.

Sorensen, P., Giovannoni, G., Montalban, X., Thalheim, C., Zaratin, P., & Comi, G. (2019). The multiple sclerosis care unit. Multiple Sclerosis (Houndmills, Basingstoke, England). 25(5), 627-636.