Table 3.

Overview of selected studies on exercise in multiple sclerosis

Form of training	Author	Method	(Major) Endpoints	Sample size	EDSS	Main Results	Comments
Aerobic training	Newman [27]	Treadmill walking	Gait parameters, Fatigue	16	<7	Improvements in some gait parameters, fatigue unchanged	Repeated measures design and blinded assessments
	Pilutti [32]	Body-weight supported treadmill training (BWSTT)	Functional ability, quality of life, Fatigue	6	5,5-8	Improvements in some functional abilities and some parameters of quality of life, Fatigue non-significantly reduced	Patients with progressive MS of high disability
	Rampello [42]	Aerobic training program compared with neurological rehabilitation	Walking parameters, maximal exercise tolerance, quality of life, fatigue	19	< 6	Improvements of some walking parameters after aerobic training, Fatigue after aerobic training and neurological rehabilitation comparable	Only 11 patients completed
	Schulz [44]	Aerobic training	Immune-endocrine parameters, neurotrophic factors, quality of life, coordinative function	67	<5	Lactate levels lowered, quality of life increased and coordinative increased
	Van den Berg [47]	Aerobic treadmill training	Walking parameters, fatigue	19	Walk 10 m in 60 s, using aid if necessary	Improvements of some walking parameters after aerobic treadmill training, fatigue not significantly reduced	Prospective, randomized controlled trial with blinded assessments, 16 patients completed
	Mostert [48]	Aerobic training	Aerobic fitness, fatigue, health perception, activity level	26	<6.5	Improvement of health perception, activity level	Randomized trial
Resistance Training	Dodd [28]	Progressive resistance strengthening	Physical, psychological, social factors	8	no information	Fatigue reduced significantly	Semi-structured interviews
	Dalgas [31]	Progressive resistance training	Muscle strength, functional capacity	38	3-5.5	Muscle strength and functional capacity increased	Randomized controlled trial including follow-up
	Harvey [39]	General physiotherapy exercises, strengthening training	Muscle strength, functional activities	19	Ambulant with or without the use of walking aids	Muscle strength and functional activities improved
	White [30]	Progressive resistance training	Lower extremity strength, ambulatory function, fatigue, disability	8	1-5	Lower extremity strength increased
	Taylor [40]	Progressive resistance training	Maximal muscle force, muscle endurance, functional activity, psychological function	9	able to walk at least 200 m without aid or rest	Improvements in muscle strength, muscle endurance, and functional activity	Pre/post single group research design
	Gutierrez [49]	Resistance training	Kinematic gait parameters, isometric strength, stepping, fatigue, disability	8	2.5-5.5	Increases in some kinematic gait parameters, fatigue decreased
	Broekmans [101]	Resistance training	Muscle strength, functional mobility	36	2-6.5	Improvements in muscle strength and some functional parameters	Randomized controlled trial, long-term investigation (20 weeks)
Combined training	Romberg [34]	Strength, aerobic training	Walking speed, lower extremity strength, upper extremity endurance, dexterity, static balance	95	1-5.5	Walking speed improved	6-month exercise program, randomized study, 91 patients completed
	Cakit [35]	Cycling progressive resistance training, balance exercises	Walking parameters, balance, fatigue, fear of falling, depression, quality of life	45	of ≤ 6.0, ability to stand independently in upright position for >3 s	Improvements in walking parameters, fatigue, fear of falling, depression	Randomized (two exercise training and one control group), only 33 patients completed
	Smith [46]	Strengthening, stretches, fitness exercises	Function, fatigue, sensory symptoms	34	0-6	> 40% temporary increased sensory symptoms (number or intensity)	Single exercise session with follow up, all measures self-rated
	Surakka [50]	Aerobic and strength exercise	Motor fatigue	95	1-5.5	Motor fatigue reduced in women (not in men)	Randomized controlled trial
Others	Motl [17]	Wearing an accelerometer	Physical activity, quality of life, disability, fatigue, mood, pain, self-efficacy, social support	292	no information	Improvements in disability, fatigue, depression, pain, self-efficacy, social support	No specific training-protocol, completed self- report measures
	Rasova [43]	Neurophysiologically based physiotherapy, aerobic training, combined therapy	Impairment, disability, handicap, quality of life, fatigue, depression, respiratory function, physical fitness	112	0-6.5	Improvements in training groups with different impact on parameters, fatigue reduced	Randomized (three exercise training and one control group), only 95 patients completed
	Wiles [51]	Physiotherapy	Mobility, mood	42	4.0-5.5	Improvements in mobility, subjective wellbeing, and mood	Randomized controlled crossover trial