School of Allied Health (Exercise Science), Murdoch University, Murdoch, WA, Australia.
Perron Institute for Neurological and Translational Science, Perth, WA, Australia.
Mult Scler. 2023 Nov;29(13):1604-1631. doi: 10.1177/13524585231204459. Epub 2023 Oct 26.
A review of the safety profile of exercise training in multiple sclerosis (MS) has not been conducted since 2013.
We undertook a systematic review and meta-analysis of randomised controlled trials (RCTs) of exercise training published since 2013 and quantified estimated population risks of clinical relapse, adverse events (AE) and serious adverse event (SAE).
Articles reporting safety outcomes from comparisons of exercise training with non-exercise among persons with MS were identified. The risk of bias was established from study's internal validity assessed using Physiotherapy Evidence Database (PEDro). Rates and estimated mean population relative risks (RRs; 95% confidence interval (CI)) of safety outcomes were calculated, and random-effects meta-analysis estimated the mean RR.
Forty-six interventions from 40 RCTs ( = 1780) yielded 46, 40 and 39 effects for relapse, AE, adverse effects and SAE, respectively. The mean population RRs ((95% CI), -value) for relapse, AE and SAE were 0.95 ((0.61, 1.48), = 0.82), 1.40 ((0.90, 2.19), = 0.14) and 1.05 ((0.62, 1.80), = 0.85), respectively. No significant heterogeneity is observed for any outcome.
In studies that reported safety outcomes, there was no higher risk of relapse, AE, adverse effects or SAE for exercise training than the comparator. Exercise training may be promoted as safe and beneficial to persons with MS.
自 2013 年以来，尚未对运动训练在多发性硬化症（MS）中的安全性进行综述。
我们对 2013 年以后发表的运动训练随机对照试验（RCT）进行了系统回顾和荟萃分析，并量化了临床复发、不良事件（AE）和严重不良事件（SAE）的估计人群风险。
确定了比较运动训练与多发性硬化症患者非运动训练的安全性结果的文章。使用物理治疗证据数据库（PEDro）评估研究的内部有效性来确定偏倚风险。计算安全性结果的发生率和估计的人群相对风险（RR；95%置信区间（CI）），并使用随机效应荟萃分析估计平均 RR。
40 项 RCT 中的 46 项干预措施（n = 1780）分别产生了 46、40 和 39 项关于复发、AE、不良反应和 SAE 的效应。复发、AE 和 SAE 的平均人群 RR（95%CI，- 值）分别为 0.95（0.61，1.48）， = 0.82）、1.40（0.90，2.19）， = 0.14）和 1.05（0.62，1.80）， = 0.85）。任何结果均未见显著异质性。
在报告安全性结果的研究中，运动训练的复发、AE、不良反应或 SAE 风险并不高于对照组。运动训练可被推广为多发性硬化症患者的安全有效方法。
