Effect of Exercise on Fatigue in Multiple Sclerosis: A Network Meta-analysis Comparing Different Types of Exercise

Torres‐Costoso, Ana; Martínez‐Vizcaíno, Vicente; Reina‐Gutiérrez, Sara; Álvarez‐Bueno, Celia; Guzmán-Pavón, María José; Pozuelo‐Carrascosa, Diana P.; Fernández-Rodríguez, Rubén; Sánchez‐López, Mairena; Cavero‐Redondo, Iván

doi:10.1016/j.apmr.2021.08.008

Cited by 18 publications

(9 citation statements)

References 92 publications

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“…A number of randomized controlled trial studies show that exercise produces beneficial effects on mental aspects such as fatigue and cognitive performance in patients that exceed those of traditional rehabilitation measures. In addition, there are meta-analyses comparing one exercise intervention versus traditional rehabilitation measures on the physical and mental functional abilities of MS patients [ 10 , 11 ], as well as network meta-analyses comparing multiple exercise interventions versus traditional rehabilitation measures on the mental function of MS patients [ 12 , 13 ]; both provide considerable clinical evidence-based recommendations.…”

Section: Introductionmentioning

confidence: 99%

Effects of Different Exercise Therapies on Balance Function and Functional Walking Ability in Multiple Sclerosis Disease Patients—A Network Meta-Analysis of Randomized Controlled Trials

Hao

Zhang

Chen

2022

IJERPH

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The objective of this research is to assess the effects of seven different exercise therapies (aquatic exercise, aerobic exercise, yoga, Pilates, virtual reality exercise, whole-body vibration exercise, and resistance exercise) on the balance function and functional walking ability of multiple sclerosis disease patients. Materials and Methods: The effects of different exercise interventions on the balance function and functional walking ability in people with multiple sclerosis were assessed by searching five databases: PubMed, Embase, Cochrane Library, Web of Science, and CNKI; only randomized controlled trials were included. The included studies were assessed for risk of bias using the Cochrane assessment tool. Results: The RCTs were collected between the initial date of the electronic databases’ creation and May 2022. We included 31 RCTs with 904 patients. The results of the collected data analysis showed that yoga can significantly improve patients’ BBS scores (SUCRA = 79.7%) and that aquatic exercise can significantly decrease patients’ TUG scores (SUCRA = 78.8%). Conclusion: Based on the network meta-analysis, we suggest that although each type of exercise is useful, yoga, virtual reality training, and aerobic training are more effective in improving the balance function of people with MS; aquatic exercise, virtual reality training, and aerobic training are more effective in improving the functional walking ability of people with MS.

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Section: Introductionmentioning

confidence: 99%

Effects of Different Exercise Therapies on Balance Function and Functional Walking Ability in Multiple Sclerosis Disease Patients—A Network Meta-Analysis of Randomized Controlled Trials

Hao

Zhang

Chen

2022

IJERPH

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“…The first recommendation was to identify specific samples that might benefit most from exercise-based interventions for energy and fatigue. Based on this meta-analysis, persons with multiple sclerosis ( Harrison et al, 2021 ; Torres-Costoso et al, 2021 ) and fibromyalgia ( Estévez-López et al, 2021 ) may be appropriate groups to target with exercise interventions. In their manuscript, Puetz et al (2006) suggest that researchers should not just take into account the general health of participants (i.e., the absence of a chronic health condition), but also current psychological status as well.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Chronic Exercise on Energy and Fatigue States: A Systematic Review and Meta-Analysis of Randomized Trials

2022

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In this meta-analysis, we synthesized the results of randomized controlled trials of different exercise training interventions on participants’ feelings of fatigue, energy, and vitality. The search of studies was conducted using six databases as well as several other supplementary search strategies available before December 2021. The initial search generated over 3,600 articles with 81 studies (7,050 participants) and 172 effects meeting the inclusion criteria. We analyzed the effects from the studies using a meta-analytic multivariate model and considered the potential moderating effect of multiple variables. Our analysis revealed exercise to decrease the feelings of fatigue by a small effect size (g = −0.374; 95% CI [−0.521, −0.227]), increase energy by a small-to-moderate effect size (g = 0.415; 95% CI [0.252, 0.578]), and to increase the feeling of vitality by a moderate effect size (g = 0.537; 95% CI [0.404, 0.671]). All main results remained robust after several sensitivity analyses using different statistical estimators, and consideration of outlier and influential studies. Moreover, moderator analyses revealed significant effects of exercise intensity and intervention duration on fatigue, exercise intensity, and modality on energy, and participant health, exercise intensity modality, and exercise training location on vitality. We conclude that when groups adopt a moderate intensity exercise training program while participating in a randomized trial, compared to controls, this typically results in small-to-moderate average improvements in feelings of fatigue, energy, and vitality.

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“…Treadmill walking and strength training seem to be less suitable to increase cardiorespiratory fitness ( 137 ). A very recent meta-analysis concluded that combined endurance and resistance exercise programs have the highest probability to improve both subjective fatigue and objective fatigability ( 138 ). Besides potential positive effects of physical activity on cardiovascular fitness and fatigue, patients may be encouraged to participate in other exercise programs with potential benefits for quality of life, e.g., by improving bladder control ( 139 ).…”

Section: Current Concepts Of Motor Fatigue In Ms: Definitions Assessm...mentioning

confidence: 99%

The pathophysiology of motor fatigue and fatigability in multiple sclerosis

Patejdl

Zettl

2022

Front. Neurol.

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Multiple Sclerosis (MS) is a heterogeneous immune mediated disease of the central nervous system (CNS). Fatigue is one of the most common and disabling symptom of MS. It interferes with daily activities on the level of cognition and motor endurance. Motor fatigue can either result from lesions in cortical networks or motor pathways (“primary fatigue”) or it may be a consequence of detraining with subsequent adaptions of muscle and autonomic function. Programmed exercise interventions are used frequently to increase physical fitness in MS-patients. Studies investigating the effects of training on aerobic capacity, objective endurance and perceived fatigability have yielded heterogenous results, most likely due to the heterogeneity of interventions and patients, but probably also due to the non-uniform pathophysiology of fatigability among MS-patients. The aim of this review is to summarize the current knowledge on the pathophysiology of motor fatigability with special reference to the basic exercise physiology that underlies our understanding of both pathogenesis and treatment interventions.

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Effect of Exercise on Fatigue in Multiple Sclerosis: A Network Meta-analysis Comparing Different Types of Exercise

Cited by 18 publications

References 92 publications

Effects of Different Exercise Therapies on Balance Function and Functional Walking Ability in Multiple Sclerosis Disease Patients—A Network Meta-Analysis of Randomized Controlled Trials

Effects of Different Exercise Therapies on Balance Function and Functional Walking Ability in Multiple Sclerosis Disease Patients—A Network Meta-Analysis of Randomized Controlled Trials

The Effect of Chronic Exercise on Energy and Fatigue States: A Systematic Review and Meta-Analysis of Randomized Trials

The pathophysiology of motor fatigue and fatigability in multiple sclerosis

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