Cuidados paliativos e fisioterapia na esclerose múltipla: inserção precoce, funcionalidade e qualidade de vida – revisão integrativa

Introduction: Multiple sclerosis (MS) is a chronic, progressively disabling neurological disease for which early integration of palliative care and physiotherapy is recommended, although its effects remain poorly systematized. Objective: To analyze the effects of palliative care and physiotherapy, with emphasis on early integration, on functional capacity and quality of life in patients with MS. Materials and Methods: Integrative review following Whittemore and Knafl, guided by the PICO strategy, with searches in PubMed/MEDLINE, PEDro and the Virtual Health Library between August and November 2026, including studies from 2011 to 2026 in Portuguese, English and Spanish. Results: Of 113 records screened, 28 studies were included: 14 randomized clinical trials, three non-randomized or descriptive studies and 11 reviews. Immediate referral to palliative care produced inconsistent benefits, either in caregiver burden or in quality of life and symptoms, and the largest trial showed no significant effect. In severe and progressive MS, physiotherapy programs were associated with gains in mobility, motor function and quality of life, generally modest and short-lived. Physiotherapy started soon after diagnosis showed functional gains and a small improvement in physical quality of life. Conclusion: Physiotherapy provides modest and transient, but recurrent, benefits even in advanced MS, supporting its early and continuous integration into palliative care; the effects of early referral to palliative care remain uncertain.