University of Alabama at Birmingham, Birmingham, AL, USA.
Neurorehabil Neural Repair. 2020 Jul;34(7):575-588. doi: 10.1177/1545968320921836. Epub 2020 May 26.
. Exercise training is associated with functional improvements in persons with multiple sclerosis (MS), perhaps based on neuroplasticity. However, inferences regarding neuroplasticity require observations of exercise-related changes in the central nervous system that explain functional adaptations. This systematic review critically evaluated studies on exercise training, neuroimaging outcomes, and functional outcomes in MS based on consistency with a well-established conceptual model for characterizing exercise training as a possible neuroplasticity-inducing behavior in this population. . We performed targeted and comprehensive searches of multiple databases for papers involving exercise training interventions on functional and neuroimaging outcomes in persons with MS. Acceptable study designs included randomized controlled trials, single-group pre/post designs, and quasi-experimental designs. Four independent reviewers extracted relevant data from each eligible paper on characteristics of participants, exercise interventions, neuroimaging outcomes, functional outcomes, pattern of study results, and potential risks of bias. . The literature search returned only 10 papers (involving 8 original interventions) that met eligibility criteria wherein inferences regarding neuroplasticity could be drawn, based on inclusion of neuroimaging and functional endpoints. Within those 10 papers, there is mixed evidence for exercise training as a neuroplasticity-inducing behavior in persons with MS. . Such a paucity of evidence supporting exercise-induced neuroplasticity in MS is likely a product of a very small number of papers that do not sufficiently examine hypothesized mechanisms of action. Future research might consider examining specific neural changes that might result from exercise prescriptions that are specifically designed to induce certain functional changes among persons with MS.
运动训练与多发性硬化症（MS）患者的功能改善有关，这可能基于神经可塑性。然而，关于神经可塑性的推论需要观察与运动相关的中枢神经系统变化，这些变化可以解释功能适应。本系统评价批判性地评估了基于运动训练作为该人群中可能诱导神经可塑性行为的既定概念模型的一致性，对 MS 患者运动训练、神经影像学结果和功能结果的研究。我们针对涉及多发性硬化症患者功能和神经影像学结果的运动训练干预的论文，在多个数据库中进行了有针对性和全面的搜索。可接受的研究设计包括随机对照试验、单组前后设计和准实验设计。四名独立评审员从每个合格论文中提取有关参与者特征、运动干预、神经影像学结果、功能结果、研究结果模式和潜在偏倚风险的相关数据。文献检索仅返回 10 篇（涉及 8 项原始干预措施）符合资格标准的论文，这些论文可以根据纳入的神经影像学和功能终点来推断神经可塑性。在这 10 篇论文中，有混合证据表明运动训练是 MS 患者诱导神经可塑性的行为。在 MS 中支持运动诱导神经可塑性的证据如此之少，很可能是由于很少有论文没有充分检查假设的作用机制。未来的研究可能需要考虑检查特定的神经变化，这些变化可能是专门为诱导 MS 患者特定功能变化而设计的运动处方的结果。
