Safety of exercise training in multiple sclerosis: An updated systematic review and meta-analysis

Author:

Learmonth Yvonne C1234ORCID,P Herring Matthew56ORCID,Russell Daniel I7,Pilutti Lara A8ORCID,Day Sandra7,Marck Claudia H9ORCID,Chan Bryan1011ORCID,Metse Alexandra P1213,Motl Robert W14ORCID

Affiliation:

1. School of Allied Health (Exercise Science), Murdoch University, Murdoch, WA, Australia

2. Perron Institute for Neurological and Translational Science, Perth, WA, Australia

3. Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, WA, Australia

4. Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, WA, Australia

5. Physical Activity for Health Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland

6. Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland

7. Discipline of Psychology, Murdoch University, Murdoch, WA, Australia

8. Interdisciplinary School of Health Sciences, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada

9. Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia

10. Murdoch University Library, Murdoch, WA, Australia

11. Discipline of Libraries, Archives, Records and Information Science, School of Media, Creative Arts and Social Inquiry, Faculty of Humanities, Curtin University, Perth, WA, Australia

12. Discipline of Psychology, School of Health, University of the Sunshine Coast, Sunshine Coast, QLD, Australia

13. School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Australia, Newcastle, NSW, Australia

14. Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA

Abstract

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.

Publisher

SAGE Publications

Subject

Neurology (clinical),Neurology

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