Skip to main content

SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1494368

Comparison of Different Exercise Modalities on Fatigue and Muscular Fitness in Patients with Multiple Sclerosis: A Systematic Review with Network, and Dose-Response Meta-Analyses

Provisionally accepted
Xi-Nuan Zhang Xi-Nuan Zhang 1Zhi-de Liang Zhi-de Liang 2Ming-Da Li Ming-Da Li 1*
  • 1 Chengdu Sport University, Chengdu, China
  • 2 Qingdao University, Qingdao, Shandong Province, China

The final, formatted version of the article will be published soon.

    Background: Fatigue and muscular fitness are closely related to the quality of life in patients with multiple sclerosis (MS). However, the optimal exercise dosage to improve these outcomes remains unclear.We evaluated the effects of different exercise modalities and dosages on fatigue levels and muscular fitness in patients with MS.Methods: A systematic search was conducted across five electronic databases, including randomized controlled trials involving exercise interventions for patients with MS. The data covered literature from the establishment of each database up to August 2024. Two independent reviewers assessed the quality of the studies. Network and dose-response meta-analyses were performed using a random-effects model to evaluate the impact of exercise.Results: A total of 84 papers were included, involving 3786 participants. The network meta-analysis revealed that mind-body exercise (MBE) had the most significant effect on reducing fatigue (SMD = -0.94; 95% CrI: -1.3 to -0.6), followed by resistance training (RT) (SMD = -0.86; 95% CrI: -1.2 to -0.58), combined exercise (COM) (SMD = -0.70; 95% CrI: -1.2 to -0.22), and high-intensity interval training (HIIT) (SMD = -0.50; 95% CrI: -1.1 to 0.14). Additionally, HIIT were found to be the most effective in improving muscular fitness (SMD = -0.86; 95% CrI: -1.5 to -0.27), followed by COM (SMD = -0.81; 95% CrI: -1.2 to -0.41), MBE (SMD = -0.64; 95% CrI: -1.1 to -0.16), and RT (SMD = -0.62; 95% CrI: -0.89 to -0.16). Moreover, a dose as low as 240 METsmin/week was sufficient to improve fatigue, while a dose of 430 METs-min/week was required to enhance muscular fitness. The optimal dose for reducing fatigue was 650 METs-min/week, and the best dose for improving muscular fitness was 530 METsmin/week.Exercise is an effective method for improving fatigue and muscular fitness in patients with MS. While MBE and COM rank relatively higher compared to other exercise modalities. The optimal exercise dosage for reducing fatigue and improving muscular fitness ranges between approximately 530 to 860 MET-minutes per week.

    Keywords: Multiple Sclerosis, Fatigue, muscular fitness, exercise interventions, Meta - analysis

    Received: 18 Sep 2024; Accepted: 14 Nov 2024.

    Copyright: © 2024 Zhang, Liang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ming-Da Li, Chengdu Sport University, Chengdu, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.