Rinaldo Natascia, Pasini Alba, Straudi Sofia, Piva Giovanni, Crepaldi Anna, Baroni Andrea, Caruso Lorenzo, Manfredini Fabio, Lamberti Nicola
Department of Neuroscience and Rehabilitation, University of Ferrara, 44124 Ferrara, Italy.
Doctoral Program in Environmental Sustainability and Wellbeing, Department of Humanities, University of Ferrara, 44121 Ferrara, Italy.
J Funct Morphol Kinesiol. 2023 Sep 8;8(3):132. doi: 10.3390/jfmk8030132.
People with multiple sclerosis (pwMS) are affected by a wide range of disabilities, including a decrease in bone mineral density (BMD) and a worsening of body composition (BC), which negatively impact their quality of life quality. This study aims to analyze the effects of nonpharmacological interventions-in particular, physical activity, nutritional approaches, and rehabilitation-on BC and BMD in pwMS. This systematic review and meta-analysis was performed following the updated version of the PRISMA guidelines. In July 2022, five databases (MEDLINE, Embase, The Cochrane Library, Google Scholar, Web of Science) and gray literature were screened. Relevant articles published between 1 January 1990 and 1 September 2022 in any language were included. Outcomes of interest were anthropometric, BC measures, and BMD. The RoB 2.0 tool was used to assess the risk of bias. After duplicates elimination, 1120 records were screened, and 36 studies were included. A total of 25 articles were focused on physical activity and rehabilitation, 10 on nutrition, and 1 on multimodal intervention. One-third of the studies were judged to be at high risk of bias. The meta-analysis showed a high degree of heterogeneity due to the high variability in disease severity and intervention duration, intensity, frequency, and type. In general, no intervention showed consistent positive effects on BC. However, the most promising interventions seemed to be high-intensity training and ketogenic diets. Only a few studies considered BMD, and the results are inconsistent. Nevertheless, more studies are needed in order to confirm these results.
多发性硬化症患者（pwMS）受到多种残疾的影响，包括骨矿物质密度（BMD）降低和身体成分（BC）恶化，这些对他们的生活质量产生负面影响。本研究旨在分析非药物干预措施，特别是体育活动、营养方法和康复对pwMS患者的BC和BMD的影响。本系统评价和荟萃分析是按照PRISMA指南的更新版本进行的。2022年7月，对五个数据库（MEDLINE、Embase、Cochrane图书馆、谷歌学术、科学网）和灰色文献进行了筛选。纳入了1990年1月1日至2022年9月1日期间以任何语言发表的相关文章。感兴趣的结果是人体测量、BC测量和BMD。使用RoB 2.0工具评估偏倚风险。在消除重复记录后，筛选了1120条记录，纳入了36项研究。共有25篇文章关注体育活动和康复，10篇关注营养，1篇关注多模式干预。三分之一的研究被判定存在高偏倚风险。由于疾病严重程度以及干预持续时间、强度、频率和类型的高度变异性，荟萃分析显示出高度的异质性。总体而言，没有干预措施对BC显示出一致的积极影响。然而，最有前景的干预措施似乎是高强度训练和生酮饮食。只有少数研究考虑了BMD，结果并不一致。尽管如此，仍需要更多研究来证实这些结果。
