Universität zu Köln

Proschinger, Sebastian, Kuhwand, Puya, Rademacher, Annette, Walzik, David ORCID: 0000-0002-9577-1435, Warnke, Clemens ORCID: 0000-0002-3510-9255, Zimmer, Philipp and Joisten, Niklas ORCID: 0000-0002-9947-8746 (2022). Fitness, physical activity, and exercise in multiple sclerosis: a systematic review on current evidence for interactions with disease activity and progression. J. Neurol., 269 (6). S. 2922 - 2941. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-1459

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Abstract

Background A moderate to high level of physical activity, including regular exercise, represents an established behavioral and rehabilitative approach for persons with multiple sclerosis (pwMS). Although being increasingly proposed to limit disease activity and progression, high-quality evidence is lacking. Objective The objective of the study is to provide valuable information for MS clinicians and researchers by systematically evaluating the current state of evidence (i) whether exercise interventions affect established clinical measures of disease activity and progression in pwMS (i.e., EDSS, relapse rate, lesion load, brain volume, MSFC) and (ii) how the physical activity and fitness level interact with these measures. Methods Literature search was conducted in MEDLINE, EMBASE, CINAHL, and SPORTDiscus. Evaluation of evidence quality was done based on standards published by The American Academy of Neurology. Results It is likely that exercise improves the MSFC score, whereas the EDSS score, lesion load, and brain volume are likely to remain unchanged over the intervention period. It is possible that exercise decreases the relapse rate. Results from cross-sectional studies indicate beneficial effects of a high physical activity or fitness level on clinical measures which, however, is not corroborated by high evidence quality. Conclusions A (supportive) disease-modifying effect of exercise in pwMS cannot be concluded. The rather low evidence quality of existing RCTs underlines the need to conduct more well-designed studies assessing different measures of disease activity or progression as primary end points. A major limitation is the short intervention duration of existing studies which limits meaningful exercise-induced effects on most disability measures. Findings from cross-sectional studies are difficult to contextualize regarding clinical importance due to their solely associative character and low evidence quality. PROSPERO registration number CRD42020188774.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Proschinger, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhwand, Puya UNSPECIFIED UNSPECIFIED UNSPECIFIED Rademacher, Annette UNSPECIFIED UNSPECIFIED UNSPECIFIED Walzik, David UNSPECIFIED orcid.org/0000-0002-9577-1435 UNSPECIFIED Warnke, Clemens UNSPECIFIED orcid.org/0000-0002-3510-9255 UNSPECIFIED Zimmer, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Joisten, Niklas UNSPECIFIED orcid.org/0000-0002-9947-8746 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-675827
DOI:	10.1007/s00415-021-10935-6
Journal or Publication Title:	J. Neurol.
Volume:	269
Number:	6
Page Range:	S. 2922 - 2941
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1432-1459
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUALITY-OF-LIFE; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; GRAY-MATTER VOLUME; CARDIORESPIRATORY FITNESS; AEROBIC EXERCISE; FUNCTIONAL STATUS; BRAIN ATROPHY; DISABILITY; FATIGUE; CAPACITY Multiple languages Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67582