Bansi 2013.

Methods	Design: random assignment to Ergometer Land Group (ELG) or Ergometer Water Group (EWG) Setting: Department of Sports Therapy, Rehabilitationsklinik Valens, Valens, Switzerland Categorization: ELG = endurance, EWG = endurance
Participants	n = 60; ELG = 30, EWG = 30 Inclusion criteria: EDSS 1.0‐6.5 Exclusion criteria: incontinent, persistent infections, cardiovascular and pulmonary diseases, or immunosuppressive therapy Type MS: ? Disease duration (yr) ± SD: ? Mean age (yr) ± SD: ELG = 52 ± 14.2, EWG = 50 ± 14.2 % Female (n/n group): ELG = 18/28, EWG = 17/25 Mean EDSS ± SD: ELG = 4.7 ± 1.5, EWG = 4.6 ± 1.4
Interventions	ELG: 3 weeks, 5x per week; 30‐minute physiotherapist‐led overland ergometry training at 60% of peak oxygen uptake/70% maximal heart rate EWG: 3 weeks, 5x per week; 30‐minute physiotherapist‐led aquatic training at 70% maximal heart rate corrected for water temperature (‐7 beats per minute). Water temperature at 28°C
Outcomes	FSMC, neurotrophin, cytokines
Notes	Drop‐outs ELG: 2 immunosuppressive medication during training EWG: 3 immunosuppressive medication during training, 3 unable to comply with daily time schedule Measurements Baseline, 3 weeks
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomization procedure not described
Allocation concealment (selection bias)	Unclear risk	Allocation procedure unknown
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Due to the nature of the intervention, neither participants nor personnel could be blinded
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Fatigue was self reported and therefore outcome assessment was not blinded
Incomplete outcome data (attrition bias) All outcomes	Low risk	Overall drop‐out rate < 15%, without indications of differences in reasons
Selective reporting (reporting bias)	Low risk	No selective reporting identified
Other bias	Low risk	No other sources of bias identified