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Peer-reviewedCC BY-NC-ND 4.0Progress in Rehabilitation Medicine

Current Evidence of Rehabilitation for Patients with Drug-resistant Epilepsy: Systematic Review and Meta-analysis

  • Tasuku Inaba1,2
  • Takatoshi Hara1,2
  • Ayaka Matsunaga1
  • Yuta Miyazaki1,3
  • Taiyo Kawaguchi1,3
  • Takashi Yamaguchi1,3
  • Masaki Iwasaki4
  • Keiya Iijima4
  • Kentaro Yoshida2
  • Masahiro Abo2
4 affiliations
  1. 1Department of Rehabilitation Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
  2. 2Department of Rehabilitation Medicine, Jikei University School of Medicine, Tokyo, Japan
  3. 3Department of Rehabilitation Medicine, Keio University, Tokyo, Japan
  4. 4Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
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Abstract

Objectives:: Drug-resistant epilepsy (DRE) affects 20%–30% of individuals with epilepsy and is associated with persistent seizures, cognitive and psychosocial impairments, and reduced health-related quality of life (HRQoL). Although surgery and neuromodulation are established non-pharmacological options, the role of rehabilitation remains unclear. This systematic review synthesized evidence on rehabilitation for DRE and aimed to clarify its clinical relevance in terms of seizure, motor, cognitive, and quality-of-life outcomes.

Methods:: Five databases (PubMed, CENTRAL, CINAHL, PEDro, and ProQuest) were searched for studies published between January 2015 and March 2025. Eligible studies included randomized controlled trials (RCTs), controlled clinical trials, and observational studies in patients with DRE receiving rehabilitation. The outcomes included seizure frequency, cognitive function, HRQoL, psychological health, and physical function. The methodological quality of RCTs was assessed using the PEDro scale. A narrative synthesis was performed, and meta-analyses of studies on physical exercise therapy were conducted to compare outcomes.

Results:: Eleven studies met the criteria: four RCTs, one non-RCT, and six observational studies. The interventions included physical exercise therapy (n = 4), postoperative rehabilitation after anterior temporal lobe resection or hemispherotomy (n = 4), neuropsychological rehabilitation (n = 1), monitoring daily activities (n = 1), and a qualitative study (n = 1). Meta-analyses of RCTs found no significant effects of exercise therapy on seizure frequency or HRQoL.

Conclusions:: DRE rehabilitation is multifaceted and encompasses exercises, cognitive training, and postoperative rehabilitation. Exercise therapy appears safe; however, the effects on seizure control and HRQoL are inconclusive. The limited evidence in DRE rehabilitation underscores the need for larger, methodologically rigorous trials with standardized outcomes.

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Cite

BibTeXRIS
BibTeX
@article{inaba2026current,
  title = {{Current Evidence of Rehabilitation for Patients with Drug-resistant Epilepsy: Systematic Review and Meta-analysis}},
  author = {Tasuku Inaba and Takatoshi Hara and Ayaka Matsunaga and Yuta Miyazaki and Taiyo Kawaguchi and Takashi Yamaguchi and Masaki Iwasaki and Keiya Iijima and Kentaro Yoshida and Masahiro Abo},
  journal = {Progress in Rehabilitation Medicine},
  year = {2026},
  month = oct,
  doi = {10.2490/prm.20260061},
  url = {https://doi.org/10.2490/prm.20260061},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Current Evidence of Rehabilitation for Patients with Drug-resistant Epilepsy: Systematic Review and Meta-analysis
AU  - Tasuku Inaba
AU  - Takatoshi Hara
AU  - Ayaka Matsunaga
AU  - Yuta Miyazaki
AU  - Taiyo Kawaguchi
AU  - Takashi Yamaguchi
AU  - Masaki Iwasaki
AU  - Keiya Iijima
AU  - Kentaro Yoshida
AU  - Masahiro Abo
PY  - 2026
DA  - 2026/10/31
JO  - Progress in Rehabilitation Medicine
DO  - 10.2490/prm.20260061
UR  - https://doi.org/10.2490/prm.20260061
AB  - Objectives:: Drug-resistant epilepsy (DRE) affects 20%–30% of individuals with epilepsy and is associated with persistent seizures, cognitive and psychosocial impairments, and reduced health-related quality of life (HRQoL). Although surgery and neuromodulation are established non-pharmacological options, the role of rehabilitation remains unclear. This systematic review synthesized evidence on rehabilitation for DRE and aimed to clarify its clinical relevance in terms of seizure, motor, cognitive, and quality-of-life outcomes.  Methods:: Five databases (PubMed, CENTRAL, CINAHL, PEDro, and ProQuest) were searched for studies published between January 2015 and March 2025. Eligible studies included randomized controlled trials (RCTs), controlled clinical trials, and observational studies in patients with DRE receiving rehabilitation. The outcomes included seizure frequency, cognitive function, HRQoL, psychological health, and physical function. The methodological quality of RCTs was assessed using the PEDro scale. A narrative synthesis was performed, and meta-analyses of studies on physical exercise therapy were conducted to compare outcomes.  Results:: Eleven studies met the criteria: four RCTs, one non-RCT, and six observational studies. The interventions included physical exercise therapy (n = 4), postoperative rehabilitation after anterior temporal lobe resection or hemispherotomy (n = 4), neuropsychological rehabilitation (n = 1), monitoring daily activities (n = 1), and a qualitative study (n = 1). Meta-analyses of RCTs found no significant effects of exercise therapy on seizure frequency or HRQoL.  Conclusions:: DRE rehabilitation is multifaceted and encompasses exercises, cognitive training, and postoperative rehabilitation. Exercise therapy appears safe; however, the effects on seizure control and HRQoL are inconclusive. The limited evidence in DRE rehabilitation underscores the need for larger, methodologically rigorous trials with standardized outcomes.
SN  - 2432-1354
ER  -