Safety of exercise training in multiple sclerosis: An updated systematic review and metaanalysis

Yvonne C Learmonth; Matthew P Herring; Daniel I Russell; Lara A Pilutti; Sandra Day; Claudia H Marck; Bryan Chan; Alexandra Metse; Robert W Motl

doi:10.1177/13524585231204459

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Safety of exercise training in multiple sclerosis: An updated systematic review and metaanalysis

Journal article

Open access

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Safety of exercise training in multiple sclerosis: An updated systematic review and metaanalysis

Yvonne C Learmonth, Matthew P Herring, Daniel I Russell, Lara A Pilutti, Sandra Day, Claudia H Marck, Bryan Chan, Alexandra Metse and Robert W Motl

Multiple Sclerosis Journal, Vol.29(13), pp.1604-1631

2023

DOI: https://doi.org/10.1177/13524585231204459

PMCID: PMC10637110

PMID: 37880997

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Abstract

multiple sclerosis

exercise training

relapse

adverse event

serious adverse event

Background: A review of the safety profile of exercise training in multiple sclerosis (MS) has not been conducted since 2013. Objective: We undertook a systematic review and meta-analysis of randomised controlled trials (RCTs) of exercise training published since 2013 and quantified estimated population risks of clinical relapse, adverse events (AE) and serious adverse event (SAE). Methods: Articles reporting safety outcomes from comparisons of exercise training with non-exercise among persons with MS were identified. The risk of bias was established from study’s internal validity assessed using Physiotherapy Evidence Database (PEDro). Rates and estimated mean population relative risks (RRs; 95% confidence interval (CI)) of safety outcomes were calculated, and random-effects meta-analysis estimated the mean RR. Results: Forty-six interventions from 40 RCTs (N = 1780) yielded 46, 40 and 39 effects for relapse, AE, adverse effects and SAE, respectively. The mean population RRs ((95% CI), p-value) for relapse, AE and SAE were 0.95 ((0.61, 1.48), p = 0.82), 1.40 ((0.90, 2.19), p = 0.14) and 1.05 ((0.62, 1.80), p = 0.85), respectively. No significant heterogeneity is observed for any outcome. Conclusion: In studies that reported safety outcomes, there was no higher risk of relapse, AE, adverse effects or SAE for exercise training than the comparator. Exercise training may be promoted as safe and beneficial to persons with MS.

Details

Title: Safety of exercise training in multiple sclerosis: An updated systematic review and metaanalysis
Authors: Yvonne C Learmonth (Corresponding Author) - Murdoch University
Matthew P Herring (Author) - University of Limerick
Daniel I Russell (Author) - Murdoch University
Lara A Pilutti (Author) - University of Ottawa
Sandra Day (Author) - Murdoch University
Claudia H Marck (Author) - The University of Melbourne
Bryan Chan (Author) - Murdoch University
Alexandra Metse (Author) - University of the Sunshine Coast, Queensland, School of Health - Psychology
Robert W Motl (Author) - University of Illinois Chicago
Publication details: Multiple Sclerosis Journal, Vol.29(13), pp.1604-1631
Publisher: Sage Publications Ltd.
Date published: 2023
DOI: 10.1177/13524585231204459
ISSN: 1477-0970
PMID: 37880997; PMC10637110
Copyright note: © The Author(s), 2023. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Organisation Unit: School of Health - Psychology
Language: English
Record Identifier: 99972098702621
Output Type: Journal article

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