Motl Robert W, Pilutti Lara A
Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 West Taylor St, Applied Health Sciences Building, Room 506J, Chicago, IL, 60612, USA.
Interdisciplinary School of Health Sciences, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada.
Neurol Ther. 2024 Dec;13(6):1559-1569. doi: 10.1007/s40120-024-00656-z. Epub 2024 Sep 13.
Exercise training represents a health behavior for the treatment and management of the multi-faceted manifestations of multiple sclerosis (MS). This paper provides a comprehensive overview of evidence from randomized controlled trials (RCTs) regarding benefits, safety, participation, and guidelines for exercise training in MS, based on systematic reviews and meta-analyses. The paper then provides our opinions based on extensive experience regarding challenges for improving and expanding future RCTs that will advance our understanding of exercise training in MS. The comprehensive review of evidence from RCTs indicates that exercise training yields substantial improvements in aerobic and muscle fitness, mobility, fatigue and depression, quality of life, and participation outcomes. There is a non-significant increase in the risk of adverse events or serious adverse events with exercise training compared with control conditions or healthy populations. Rates of adherence and compliance with exercise training (i.e., participation) approximate 80% and 70%, respectively. The current prescriptive guidelines suggest 2-3 days per week of aerobic and resistance exercise training as the minimal dose for safely benefiting from exercise training in MS. We propose 10 important topics as avenues for expanding the body of research and improving its scope for evidence-based practice in MS. Overall, the research on exercise training in MS is strong, but it can get stronger. The expansion and advancement of evidence are critical for moving exercise training into the clinical armamentarium of MS disease treatment and management.
运动训练是一种用于治疗和管理多发性硬化症（MS）多方面表现的健康行为。本文基于系统评价和荟萃分析，全面概述了随机对照试验（RCT）中有关MS运动训练的益处、安全性、参与情况和指南的证据。然后，本文根据丰富经验，就改进和扩大未来RCT的挑战提出了我们的观点，这些RCT将推进我们对MS运动训练的理解。对RCT证据的全面审查表明，运动训练在有氧和肌肉适应性、运动能力、疲劳和抑郁、生活质量以及参与结果方面有显著改善。与对照条件或健康人群相比，运动训练导致不良事件或严重不良事件风险的增加不显著。运动训练的依从率和遵从率（即参与率）分别约为80%和70%。当前的规范性指南建议，每周进行2至3天的有氧和抗阻运动训练，作为在MS中从运动训练中安全获益的最小剂量。我们提出10个重要主题，作为扩大MS研究范围和提高其循证实践范围的途径。总体而言，MS运动训练的研究很充分，但可以更充分。证据的扩展和推进对于将运动训练纳入MS疾病治疗和管理的临床手段至关重要。
