Table 2.
Characteristics of the included studies.
| Author and Year | Sex | Sample CG/IG |
Control Group | Intervention Group | Results | ||||
|---|---|---|---|---|---|---|---|---|---|
| Disability Range of the Included Patients | Age Mean ± SD Median (IQR) |
Treatment | Exercise Parameters | EDSS Score Pre-Intervention Mean ± SD Median (IQR) |
|||||
| Akbar et al. [35] | F: 100% | 5/5 | Fully ambulatory/ability to walk without an assistive device | Stretching | 45.6 ± 12.8 | Progressive resistance training | I: Adjusted to each participant F: 3 times/week #S: 48 sessions D: 600 min |
Not reported | Progressive resistance training improves fatigue (main effect of time: F = 0.84, d = 0.65), functional connectivity between the left inferior caudate and parietal (F = 66.0, p < 0.001), bilateral frontal (both p < 0.001), and right insula (F = 21.8, p = 0.002) regions and grip strength (d = 1.11). |
| Arntzen et al. [36] | F: 69.2% M: 30.8% |
40/39 | EDSS 1–6.5; mean = 2.37 | Usual care + walking | 52.2 ± 12.9 | Dynamic core stability training | I: Adjusted to each participant F: 3 times/week #S: 18 sessions D: 60 min |
2.45 ± 1.65 | Dynamic core stability training significantly improved walking (2MWT) immediately after the intervention for up to 24 weeks of follow-up (Post: 6.7 m, 95% CI [8.15, 25.25], p < 0.001; Follow-Up: 15.08 m, 95% CI [6.39, 23.77] p = 0.001). |
| Sandroff et al. [37] | F: 85.5% M: 14.5% |
40/43 | EDSS 4–6; PDDS mean = 3.5 | Stretching and toning activities | 49.8 ± 8.5 | Aerobic, resistance, and balance exercise | I: Vigorous F: 3 times/week #S: 18 sessions D: 25 min |
Not reported | This RCT provides novel, preliminary evidence that multimodal exercise training may improve endurance walking (r = 0.25) performance and cognitive processing speed. |
| Sosnoff et al. [38] | F: 77.7% M: 22.3% |
14/13 | EDSS 2.5–6.5; mean = 5 | Waiting list | 60.0 ± 6.1 | Balance, walking and resistance training | I: Adjusted to each participant F: 3 times/week #S: 38 sessions D: 45–60 min |
5.5 ± 2.5 | A home-based exercise program enhanced walking (T25FW, Pre: 6.6 ± 1.3; Post: 6.4 ± 1.4; p = 0.040). |
| Callesen et al. [39] | M: 23% F: 77% |
20/23 | EDDS 2.0–6.5; mean = 3.5 | Usual care | 52 (30–75) |
Progressive resistance training | I: Moderate F: 2 times/week #S: 21 sessions D: 60 min |
4 (2–6.5) | Progressive resistance training reduced fatigue impact, however, had no impact on gait when compared to control group (Mean diff: 0.02; 95% CI [−0.08; 0.13], p = 0.660) |
| Correale et al. [40] | F: 100% | 9/14 | Mean EDSS = 2.25 | Usual care | 45.4 ±7.2 | Endurance and resistance training | I: Moderate to Vigorous F: 2 times/week #S: 24 sessions D: 30 min |
Not reported | Endurance and resistance training leads to enhanced muscle strength, along with decreased fatigue, depressive symptoms, and greater overall health-related quality of life (p < 0.05). Notably, these positive changes endure even after a 12-week period of detraining. |
| Uszynski et al. [41] | M: 28.57% F: 71.43% |
13/14 | Participants with MS who walked independently or used an assistive device with scores of 0, 1, 2, and 3, inclusive on the Guys Neurological Disability scale (GNDS). | Resistance training | 45.5 (38.5–52.3) |
Vibration + resistance training | I: Moderate to Vigorous F: 3 times/week #S: 36 sessions D: 20 min |
Not reported | No between group differences were found for muscle strength, balance, or gait (p > 0.05). |
| Learmonth et al. [42] | F: 96.55% M: 3.45% |
28/29 | EDSS 1–6; mean = 1.5 | Waitlist | 48.4 ± 9.7 | Resistance and aerobic training | I: Mild to moderate F: 4 times/week #S: 64 sessions D: 45 min |
1.25 ± 2.5 | A small, non-statistically significant effect size of combined exercise on MSWS-12 in patients with MS is presented. (Cohen’s D: −0.10, F: 0.47) |
| Manca et al. [43] | F: 80% M: 20% |
15/15 | EDDS ≤ 6; mean = 3.4 | Contralateral resistance training | 47.3 ± 9.4 | Direct resistance training | I: Vigorous F: 3 times/week #S: 18 sessions D: 25 min |
3.0 ± 1.00 | Both direct and indirect resistance training led to significant gains in muscle strength. However, only direct resistance training increased walking speed (Pre: 085 ± 0.14; Post: 0.99 ± 0.15; p < 0.0001) |
| Medina-Perez et al. [44] | NR | 12/30 | Mean EDSS = 4.3 | Usual care | 49.6 ± 11 | Resistance training | I: Vigorous F: 3 times/week #S: 18 sessions D: 25 min |
4.5 ± 2.1 | A 12-week RTP improved extension, maximal voluntary isometric contraction, and muscle power in MS patients. |
| Braendvik et al. [45] | M: 34.6% F: 65.4% |
11/15 | EDSS ≤ 6; mean = 3.15 | Treadmill training | 49.1 ± 6.2 | Resistance training | I: Moderate to Vigorous F: 3 times/week #S: 24 sessions D: 30 min |
3.2 ± 1.4 | Resistance training had no significant effect over gait assessed with the Functional Ambulation Profile (Pre: 91.7, Post: 90.3; p = 0.844) |
| Pau et al. [46] | M: 54.54% F: 45.45% |
11/11 | EDSS 1.5–5.5; mean = 3.5 | Usual care | 47.4 ± 10.8 | Aerobic and resistance training | I: Moderate F: 3 times/week #S: 72 sessions D: 60 min |
3.6 ± 0.9 | Although some improvements have been observed, the substantial constancy of kinematic patterns of gait suggests that the full transferability of the administered training on the ambulation function may require more specific exercises. |
Abbreviations. I: Intensity; F: Frequency; #S: Number of Sessions; D: Duration; CG: Control Group; IG: Intervention Group; SD: Standard Deviation; IQR: Interquartile Range; MS: Multiple Sclerosis; 2MWT: 2-Minute Walk Test; MSWS-12: 12-item Multiple Sclerosis Walking Scale; RTP: Resistance Training Program; RCT: Randomized Controlled Trial; T25FW: Timed 25-Foot Walk; GNDS: Guys Neurological Disability Scale; EDSS: Expanded Disability Status Scale.