A narrative review of clinical practice guidelines for the application of physical therapy and rehabilitation procedures in the management of multiple sclerosis

Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by neuroinflammation and progressive neurodegeneration, leading to significant physical and cognitive impairments. Rehabilitation, particularly physical therapy, has emerged as a crucial component in managing MS-related disability by improving mobility, reducing fatigue, and enhancing overall quality of life. This narrative review investigates current international guidelines on physical therapy and rehabilitation for MS. Literature search in databases (January 2010 until August 2025) resulted in three guidelines that met the inclusion criteria. Evidence suggests that structured aerobic and resistance training programmes, combined with balance and flexibility exercises, contribute significantly to maintaining functional independence. Additionally, assistive technologies offer promising advances in patient-centred care. However, challenges such as limited accessibility, variability in disease presentation, and adherence to rehabilitation programmes pose significant barriers. This narrative review highlights the need for comprehensive and multidisciplinary clinical guidelines to optimize physical therapy interventions and improve the long-term well-being of MS patients.