The aim of this study was to summarize current evidence regarding the effectiveness of neurorehabilitation strategies in patients with Neuromyelitis Optica Spectrum Disorder (NMOSD). The study was conducted as a narrative review of scientific publications identified in the PubMed, EMBASE, Ovid, and PEDro databases over the past 10 years. Clinical studies, systematic reviews, meta-analyses, consensus documents, and clinical guidelines focusing on physical therapy, occupational therapy, gait rehabilitation, spasticity management, and the treatment of pain, fatigue, visual, cognitive, and psychoemotional impairments in NMOSD were analyzed.

The review demonstrated that early and continuous neurorehabilitation integrated into the overall patient management strategy is the most effective approach. During the acute phase, the primary objectives include prevention of complications, early mobilization, and maintenance of physical activity. In the early recovery phase, rehabilitation efforts should focus on restoring gait, muscle strength, coordination, balance, and upper limb function. In contrast, the late recovery and chronic phases emphasize occupational therapy, social reintegration, and the management of fatigue, pain, bladder dysfunction, and psychoemotional disorders. Rehabilitation outcomes are largely influenced by the serological phenotype of the disease, the severity of previous attacks, and the effectiveness of immunosuppressive therapy.

It was concluded that neurorehabilitation should be regarded as an essential component of long-term NMOSD management. Promising directions include the implementation of personalized rehabilitation programs, telerehabilitation, robotic-assisted technologies, and multidisciplinary models of care, which may contribute to improved functional independence and quality of life in affected patients.