Effectiveness of technology-based exercise on motor function and quality of life in individuals with multiple sclerosis: an umbrella review

This umbrella review evaluated the effects of Technology-Based Exercise (Tele-exercise) on balance and Quality of Life (QoL) in individuals with multiple sclerosis (MS). A comprehensive search across multiple databases identified meta-analyses and individual studies published up to June 3, 2025. Eligible studies included meta-analyses assessing tele-exercise interventions, while reviews with insufficient data were excluded. Methodological quality was assessed using the Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) checklist. The pooled findings indicate that tele-exercise is not associated with meaningful improvements in balance among individuals with multiple sclerosis (SMD = 0.587, 95% CI: -0.533-1.706, N = 243 based on SMD). Likewise, tele-exercise shows minimal impact on quality of life (QOL) (SMD = 0.169, 95% CI: -0.025-0.362, N = 407 based on SMD). Although trends toward benefit were observed, findings remain inconclusive due to variability in protocols, methodological limitations, and low patient engagement. Overall, tele-exercise is feasible and may support patient-centered care, but current evidence does not confirm significant improvements in balance and QoL for people with MS. Standardized protocols, greater personalization, and higher-quality trials are needed to strengthen future clinical guidelines.