Table 4.
Epidemiological and clinical studies of physical activity and exercise in multiple sclerosis.
| Study type, country, year | Sample size | Follow-up, time | Physical activity category, intensity | Statistics | Main outcome |
|---|---|---|---|---|---|
| Cross-sectional, USA, 2011 (Cavanaugh et al., 2011) | MS:21 | 1 week | Daily step count | r = −0.90, p < 0.01 | Total step counts count correlated negatively with EDSS. |
| Cross-sectional, USA, 2015 (Fjeldstad et al., 2015) | MS: 13 HC: 12 | 1 week | Daily step count (accelerometer) | r = −0.61, p < 0.05 | Total weekly step counts correlated negatively with EDSS. |
| Cross-sectional, USA, 2015 (Klaren et al., 2015) | MS: 39 | 1 week | PA level (accelerometer) Sedentary ( ≤ 100 counts/min) LPA (100–1,722 counts/min) MVPA (≥1,723 counts/min) | Hippocampus (pr = 0.49, p < 0.01) Thalamus (pr = 0.38, p < 0.05) Caudate (pr = 0.54, p < 0.01) Putamen (pr = 0.37, p < 0.05) Pallidum (pr = 0.50, p < 0.01) | MVPA was associated with whole brain gray and white matter volumes and brain structures involved in motor and cognition in MS patients. |
| Cross-sectional, 2017, USA (Block et al., 2017) | MS: 99 | >4 weeks | Daily step count (accelerometer) | r = −0.71, p < 0.001 | Daily step count correlated negatively with EDS. Lower PA was associated with greater disability. |
| Prospective, 2019, USA (Block et al., 2019) | MS: 95 | 1 year | Daily step count (accelerometer) | OR = 4.01, 95% CI [1.17–13.78], p = 0.03 | Participants with an average daily step count below 4,766 had higher odds of disability according to the EDSS score. |
| Cross-sectional, retrospective, 2020, Israel (Kalron et al., 2020) | MS: 153 | N.A | Leisure time PA | Physically active: hippocampus (48.5, S.D = 32.2) Insufficiently active: hippocampus (34.6, S.D = 30.8, p = 0.004) |
Patients who engaged in regular PA maintain their hippocampal volume. |
| RCT, 2004, Finland (Romberg et al., 2004) | MS: 95 | 6 months | Strength and aerobic training | Physically active: the 7.62 m walk test time decreased by 12% (95% CI 15% to 7%, p < 0.001). | Exercising patients improved their walking speed assessed with the 7.62m and 500 m walking tests. |
| RCT, 2015, Belgium (Wens et al., 2015) | MS: 34 | 12 weeks | High-intensity exercise High-intensity cardiovascular training | Mean muscle fibers crossectional area (HIT:+21 ± 7%, HCT:+23 ± 7%) | High-intensity interval (HIT) and continuous cardiovascular exercise (HCT) was safe and increased mean muscle fibers‘crossectional area. |
| Cross-sectional, 2022, USA (Kim et al., 2022) | MS: 41 HC: 79 | 1 week | MVPA | RFNL (r = 0.38, p < 0.01) TMV (r = 0.49, p < 0.01) | MVPA correlated with retinal nerve fiber thickness (RNFL) and total macular volume (TMV). |
EDSS, Expanded Disability Status Scale PA, physical activity; LPA, light physical activity; MVPA, moderate to vigorous physical activity; OR, odds ratio; pr, partial correlation; RCT, randomized controlled trial; N.A, not applicable.