Department of Public Health, Section for Sport Science, Aarhus University, Aarhus, Denmark.
Department of Neurology, Hospital of Southern Jutland, Sønderborg, Denmark.
Curr Neurol Neurosci Rep. 2019 Nov 13;19(11):88. doi: 10.1007/s11910-019-1002-3.
For many years, exercise was controversial in multiple sclerosis (MS) and thought to exacerbate symptoms and fatigue. However, having been found to be safe and effective, exercise has become a cornerstone of MS rehabilitation and may have even more fundamental benefits in MS, with the potential to change clinical practice again. The aim of this review is to summarize the existing knowledge of the effects of exercise as primary, secondary, and tertiary prevention in MS.
Initial studies established exercise as an effective symptomatic treatment (i.e., tertiary prevention), but recent studies have evaluated the disease-modifying effects (i.e., secondary prevention) of exercise as well as the impact on the risk of developing MS (i.e., primary prevention). Based on recent evidence, a new paradigm shift is proposed, in which exercise at an early stage should be individually prescribed and tailored as "medicine" to persons with MS, alongside conventional medical treatment.
多年来，运动在多发性硬化症（MS）中一直存在争议，被认为会加重症状和疲劳。然而，运动已被证明是安全有效的，它已成为 MS 康复的基石，甚至可能在 MS 中具有更根本的益处，有可能再次改变临床实践。本文综述的目的是总结运动作为多发性硬化症一级、二级和三级预防的现有知识。
最初的研究确立了运动作为一种有效的对症治疗（即三级预防），但最近的研究评估了运动对疾病的调节作用（即二级预防）以及对多发性硬化症发病风险的影响（即一级预防）。基于最近的证据，提出了一个新的范式转变，即在早期阶段，运动应该作为“药物”，根据个人情况量身定制，并与常规药物治疗一起，用于多发性硬化症患者。
