不同运动方式对多发性硬化症患者疲劳和肌肉适应性的影响比较：一项基于网状分析和剂量反应荟萃分析的系统评价

Comparison of different exercise modalities on fatigue and muscular fitness in patients with multiple sclerosis: a systematic review with network, and dose-response meta-analyses.

作者信息

Zhang Xi-Nuan, Liang Zhi-De, Li Ming-Da

机构信息

School of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China.

Department of Physical Education, College of Physical Education, Qingdao University, Qingdao, China.

出版信息

Front Neurol. 2024 Nov 26;15:1494368. doi: 10.3389/fneur.2024.1494368. eCollection 2024.

DOI:10.3389/fneur.2024.1494368

PMID:39659961

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11628374/

Abstract

BACKGROUND

Fatigue and muscular fitness are closely related to the quality of life in patients with multiple sclerosis (MS). However, the optimal exercise dosage to improve these outcomes remains unclear.

OBJECTIVE

We evaluated the effects of different exercise modalities and dosages on fatigue levels and muscular fitness in patients with MS.

METHODS

A systematic search was conducted across five electronic databases, including randomized controlled trials involving exercise interventions for patients with MS. The data covered literature from the establishment of each database up to August 2024. Two independent reviewers assessed the quality of the studies. Network and dose-response meta-analyses were performed using a random-effects model to evaluate the impact of exercise.

RESULTS

A total of 84 papers were included, involving 3,786 participants. The network meta-analysis revealed that mind-body exercise (MBE) had the most significant effect on reducing fatigue (SMD = -0.94; 95% CrI: -1.3 to -0.6), followed by resistance training (RT) (SMD = -0.86; 95% CrI: -1.2 to -0.58), combined exercise (COM) (SMD = -0.70; 95% CrI: -1.2 to -0.22), and high-intensity interval training (HIIT) (SMD = -0.50; 95% CrI: -1.1 to 0.14). Additionally, HIIT were found to be the most effective in improving muscular fitness (SMD = -0.86; 95% CrI: -1.5 to -0.27), followed by COM (SMD = -0.81; 95% CrI: -1.2 to -0.41), MBE (SMD = -0.64; 95% CrI: -1.1 to -0.16), and RT (SMD = -0.62; 95% CrI: -0.89 to -0.16). Moreover, a dose as low as 240 METs-min/week was sufficient to improve fatigue, while a dose of 430 METs-min/week was required to enhance muscular fitness. The optimal dose for reducing fatigue was 650 METs-min/week, and the best dose for improving muscular fitness was 530 METs-min/week.

CONCLUSION

Exercise is an effective method for improving fatigue and muscular fitness in patients with MS. While MBE and COM rank relatively higher compared to other exercise modalities. The optimal exercise dosage for reducing fatigue and improving muscular fitness ranges between approximately 530 to 860 MET-minutes per week.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/, CRD42024577643.

摘要

背景

疲劳和肌肉健康与多发性硬化症（MS）患者的生活质量密切相关。然而，改善这些结果的最佳运动剂量仍不明确。

目的

我们评估了不同运动方式和剂量对MS患者疲劳水平和肌肉健康的影响。

方法

在五个电子数据库中进行了系统检索，包括涉及MS患者运动干预的随机对照试验。数据涵盖了每个数据库建立至2024年8月的文献。两名独立评审员评估了研究质量。使用随机效应模型进行网络和剂量反应荟萃分析，以评估运动的影响。

结果

共纳入84篇论文，涉及3786名参与者。网络荟萃分析显示，身心运动（MBE）对减轻疲劳的效果最显著（标准化均数差[SMD]=-0.94；95%可信区间[CrI]：-1.3至-0.6），其次是抗阻训练（RT）（SMD=-0.86；95%CrI：-1.2至-0.58）、联合运动（COM）（SMD=-0.70；95%CrI：-1.2至-0.22）和高强度间歇训练（HIIT）（SMD=-0.50；95%CrI：-1.1至0.14）。此外，发现HIIT在改善肌肉健康方面最有效（SMD=-0.86；95%CrI：-1.5至-0.27），其次是COM（SMD=-0.81；95%CrI：-1.2至-0.41）、MBE（SMD=-0.64；95%CrI：-1.1至-0.16）和RT（SMD=-0.62；95%CrI：-0.89至-0.16）。此外，低至240梅脱-分钟/周的剂量就足以改善疲劳，而增强肌肉健康则需要430梅脱-分钟/周的剂量。减轻疲劳的最佳剂量为650梅脱-分钟/周，改善肌肉健康的最佳剂量为530梅脱-分钟/周。