This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.
Megha Masaun, Mansi Gupta. Physiotherapy Management of Multiple Sclerosis: An Overview of Recent Technological Advances. Therapy Jr. 2026; 19(2): 167-173.
Timeline
Received : May 02, 2026
Accepted : June 04, 2026
Published : June 30, 2026
Abstract
Multiple Sclerosis (MS) is a chronic autoimmune condition characterized by complex motor and cognitive impairments that necessitate intensive, long-term Physiotherapy. Recent advances in Physiotherapy have shifted towards technologyintegrated approach, leveraging Virtual Reality (VR), Robot-Assisted Gait Training (RAGT), and Transcranial Direct Current Stimulation (tDCS) to enhance neuroplasticity. VR provides immersive, biofeedback-driven environments that improve postural control and patient adherence through gamification. RAGT facilitates high-intensity, repetitive gait cycles essential for improving walking endurance in severely disabled populations. Concurrently, tDCS has emerged as
a potent non-invasive neuromodulatory tool to mitigate Multiple Sclerosis related fatigue and cognitive dysfunction. This review highlights how the synergy of digital innovation and evidence-based Physiotherapy is fostering a more personalized, effective, and accessible rehabilitation model, ultimately aiming to delay disability progression and improve the quality of life for individuals living with MS.
References
1. The Lancet Neurology. 2008; 7(9): 841–851. doi: 10.1016/s1474-4422(08)70191-1.
2. Yvonne C. Learmonth, Physiotherapy management of multiple sclerosis, Journal of Physiotherapy, 72, (1), 2026, 11-22.
3. Turk A., Maver A., Juvan P., Drulović J., Mesaroš Š., Novaković I., et al. Increased burden of rare variants in GWAS associated genes in familial multiple sclerosis. Sci Rep 2025; 15: 21200.
4. Huang J., Kockum I., Stridh P. Trends in the environmental risks associated with earlier onset in multiple sclerosis. Mult Scler Relat Disord 2022; 68: 104250.
5. Walton, C., King, R., Rechtman, L., Kaye, W., Leray, E., Marrie, R. A., Robertson, N., La Rocca, N., Uitdehaag, B., van Der Mei, I., et al. (2020). Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS. Multiple Sclerosis Journal, 26(14), 1816-1821.
7. Simpson M., Macdonell R. The use of transcranial magnetic stimulation in diagnosis, prognostication and treatment evaluation in multiple sclerosis. Mult Scler Relat Disord (2015) 4: 430–36. doi: 10.1016/j.msard.2015.06.014).
8. White L.J., Castellano V. Exercise and brain health–implications for multiple sclerosis: Part 1–neuronal growth factors. Sports Med (2008) 38: 91–100.
9. Yang, F.A., Lin, C.L., Huang, W.C., Wang, H.Y., Peng, C.W., & Chen, H.C. (2023). Effect of robotassisted gait training on multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials. Neurorehabilitation and Neural Repair, 37(4), 228-239.
10. Casuso-Holgado, M.J., Martín-Valero, R., Carazo, A.F., Medrano-Sánchez, E.M., CortésVega, M.D., & Montero-Bancalero, F.J. (2018). Effectiveness of virtual reality training for balance and gait rehabilitation in people with multiple sclerosis: a systematic review and meta-analysis. Clinical Rehabilitation, 32(9), 1220-1234.
11. Valodwala, K.C. (2026). Recent advances in physiotherapy management of multiple sclerosis: a scoping review. International Journal of Research in Medical Sciences, 14 (4), 1735–1737.
12. Karakaş, Hilal & Seebacher, Barbara & Kahraman, Turhan. (2021). TechnologyBased Rehabilitation in People with Multiple Sclerosis: A Narrative Review. Journal of Multiple Sclerosis Research. 1. 54 - 68. 10.4274/jmsr.galenos.2021.2021-10-3.
13. Burke M.J., Fried P.J., Pascual-Leone A. Transcranial magnetic stimulation: Neurophysiological and clinical applications. Handb Clin Neurol (2019) 163: 73–92. doi:10.1016/B978-0-12-804281-6.00005-7
14. Zhou X., Li K., Chen S., Zhou W., Li J., Huang Q., Xu T., Gao Z., Wang D., Zhao S., Dong H. Clinical application of transcranial magnetic stimulation in multiple sclerosis. Front Immunol. 2022 Sep 5; 13: 902658. doi: 10.3389/fimmu.2022.902658.
15. D. Centonze, G. Koch, V. Versace, F. Mori, S. Rossi, L. Brusa, et al. Repetitive transcranial magnetic stimulation of the motor cortex ameliorates spasticity in multiple sclerosis. Neurology, 68 (2007), pp. 1045-1050.
16. D. Centonze, F. Petta, V. Versace, S. Rossi, F. Torelli, C. Prosperetti, et al.
17. Effects of motor cortex rTMS on lower urinary tract dysfunction in multiple sclerosis.Mult Scler, 13 (2007), pp. 269-271.
18. Cullen C.L., Senesi M., Tang A.D., Clutterbuck M.T., Auderset L., O’Rourke M.E., et al. Lowintensity transcranial magnetic stimulation promotes the survival and maturation of newborn oligodendrocytes in the adult mouse brain. Glia (2019) 67(8): 1462–77.
19. Zhou X, Li K, Chen S, Zhou W, Li J, Huang Q, Xu T, Gao Z, Wang D, Zhao S, Dong H. Clinical application of transcranial magnetic stimulation in multiple sclerosis. Front Immunol. 2022 Sep 5; 13: 902658. doi: 10.3389/fimmu.2022.902658.
20. Virtual Reality Treatment for Multiple Sclerosis - Physiopedia
21. Maggio M.G., Maresca G., de Luca R., Stagnitti M.C., Porcari B., Ferrera M.C., Galletti F., Casella C., Manuli A., Calabrò R.S. The Growing Use of Virtual Reality in Cognitive Rehabilitation: Fact, Fake or Vision? A Scoping Review. J. Natl. Med. Assoc. 2019; 111: 457–463.
22. De Keersmaecker E., Guida S., Denissen S., Dewolf L., Nagels G., Jansen B., Beckwée D., Swinnen E. Virtual reality for multiple sclerosis rehabilitation. Cochrane Database Syst Rev. 2025 Jan 7;1(1): CD013834. doi: 10.1002/14651858.CD013834.pub2. PMID:39775922; PMCID: PMC11705534.
23. Massetti T., Trevizan I.L., Arab C., Favero F.M., Ribeiro-Papa D.C., de Mello Monteiro CB. Virtual reality in multiple sclerosis - A systematic review. Mult Scler Relat Disord. 2016 Jul; 8: 107-12. doi: 10.1016/j.msard.2016.05.014. Epub 2016 May 21. PMID: 27456884.
24. Raabeah Fatma Jafri, Namra Fatma Jafri, Maryam Sayeed, Mizna Musthafa, Suhana Riyas,Telehealth in Multiple Sclerosis: Fostering Quality of Life, Multiple Sclerosis and Related Disorders, Volume 80, 2023, 105280, ISSN 2211-0348.
26. Keszler P., Maloni H., Miles Z., Jin S., Wallin M. Telemedicine and Multiple Sclerosis: A Survey of Health Care Providers Before and During the COVID-19 Pandemic. Int J MS Care. 2022 Nov-Dec; 24(6): 266-270. doi: 10.7224/1537-2073.2021-103. Epub 2022 Sep 15. PMID: 36545646; PMCID: PMC9749831.
27. Andrea Baroni, Nicola Lamberti, Gabriele Perachiotti, Anna Crepaldi, Giovanni Piva, Fabio Manfredini, Sofia Straudi, Low intensity interval robot-assisted gait training improves mobility in people with rogressive multiple sclerosis: The PROGR-EX randomized controlled trial, Multiple Sclerosis and Related Disorders,Volume 104, 2025,106777.
28. Christodoulou et al., 2025 V.N. Christodoulou, D.N. Varvarousis, G. Ntritsos, D. Dimopoulos, N. Giannakeas, G.I. Vasileiadis, A. Korompilias, A. Ploumis
29. Robotic assisted and exoskeleton gait training effect in mental health and fatigue of multiple sclerosis patients. A systematic review and a meta-analysis. Disabil. Rehabil., 47 (2) (2025), pp. 302-313,.
30. Facciorusso S., Malfitano C., Giordano M., Del Furia M.J., Mosconi B., Arienti C., Cordani C. Effectiveness of robotic rehabilitation for gait and balance in people with multiple sclerosis: a systematic review. Journal of Neurology. 2024 Nov; 271(11): 7141-55.
31. Yang F.A., Lin C.L., Huang W.C., Wang H.Y., Peng C.W., Chen H.C. Effect of robot-assisted gait training on multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials. Neurorehabilitation and Neural Repair. 2023 Apr; 37(4): 228-39.
32. Calabrò R.S., Cassio A., Mazzoli D., Andrenelli E., Bizzarini E., Campanini I., Carmignano S.M., Cerulli S., Chisari C., Colombo V., Dalise S. What does evidence tell us about the use of gait robotic devices in patients with multiple sclerosis? A comprehensive systematic review on functional outcomes and clinical recommendations. European journal of physical and rehabilitation medicine. 2021; 57(5): 841-9.
33. Marotta N., de Sire A., Marinaro C., Moggio L., Inzitari M.T., Russo I., Tasselli A., Paolucci T., Valentino P., Ammendolia A. Efficacy of Transcranial Direct Current Stimulation (tDCS) on Balance and Gait in Multiple Sclerosis Patients: A Machine Learning Approach. J Clin Med. 2022 Jun 17; 11(12): 3505. doi: 10.3390/jcm11123505. PMID: 35743575; PMCID: PMC9224780.
34. Cirillo G., Di Pino G., Capone F., Ranieri F., Florio L., Todisco V., Tedeschi G., Funke K., Di Lazzaro V. Neurobiological after-effects of non-invasive brain stimulation. Brain Stimul. 2017; 10: 1–18. doi: 10.1016/j.brs.2016.11.009.
35. Paltamaa J., Sjögren T., Peurala S.H., Heinonen A. Effects of physiotherapy interventions on balance in multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials. J. Rehabil. Med. 2012; 44: 811–823. doi: 10.2340/16501977-1047.
36. Chmiel J., Kurpas D., Stępień-Słodkowska M. The Potential of Transcranial Direct Current Stimulation (tDCS) in Improving Quality of Life in Patients with Multiple Sclerosis: A Review and Discussion of Mechanisms of Action. Journal of Clinical Medicine. 2025; 14(2): 373. https://doi.org/10.3390/jcm14020373
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
About this article
Cite this article
Megha Masaun, Mansi Gupta. Physiotherapy Management of Multiple Sclerosis: An Overview of Recent Technological Advances. Therapy Jr. 2026; 19(2): 167-173.
This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.
This license
enables reusers to distribute, remix, adapt, and build upon the material in any
medium or format for noncommercial purposes only, and only so long as
attribution is given to the creator.