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STUDY: The safety of exercise training in multiple sclerosis: A systematic review

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  • STUDY: The safety of exercise training in multiple sclerosis: A systematic review

    J Neurol Sci. 2014 May 15. pii: S0022-510X(14)00306-2. doi: 10.1016/j.jns.2014.05.016. [Epub ahead of print]

    The safety of exercise training in multiple sclerosis: A systematic review.

    Pilutti LA1, Platta ME2, Motl RW2, Latimer-Cheung AE3.


    There are many reviews documenting the benefits of exercise training among persons with multiple sclerosis (MS). To date, we are unaware of a review that summarizes the risks of relapse and other adverse events (AEs) associated with exercise training, yet this is critical for informing decisions and recommendations regarding the safety of this behavior.

    We conducted a systematic review of relapse and other AEs reported in randomized controlled trials (RCTs) of exercise training in MS. We searched electronic databases for RCTs of exercise training in MS. We calculated the rate of relapse and AEs, and the relative risk of relapse and AEs for exercise training versus control.

    Twenty-six studies were reviewed that included 1295 participants. We determined that the rate of relapse was 6.3% and 4.6% for control and exercise, respectively. The rate of AEs was 1.2% and 2.0% for control and exercise, respectively. The relative risk of relapse for exercise training was 0.73, whereas the relative risk of AE for exercise training was 1.67.

    Exercise training was not associated with an increased risk of relapse, and risk of AEs was not higher than in healthy populations. This evidence should alleviate uncertainty regarding the safety of exercise training in MS.

    Dave Bexfield

  • #2
    It's also interesting to note that while this study shows that exercise does not cause relapses, it also shows that exercise doesn't prevent them either. So don't chuck your DMTs out the window just yet.....
    Dave Bexfield


    • #3
      From the Rocky Mountain MS Center

      I just received this news letter from the Rocky Mountain MS Center. There is a good Q&A session with Dr. Volmer, head of RMMSC, concerning the many benefits of exercise for PWMS. We shouldn't be afraid to exercise hard, it may be one of the best things we can do for ourselves. Other good articles too.


      • #4
        I can provide some interesting anecdotal evidence (of limited use, of course) on exercise habits and relapse rate. I've been fortunate enough to have relatively few relapses so far, but all have come either in off-season or the beginning of the season with the singular exception being this past April, a month prior to Ironman Lanzarote.

        That said, following last year's significant training for Ironman New Zealand and Kona, I succeeded in burning myself out mentally for training. Despite being only a few weeks after Lanzarote, I am in the worst fitness level in nearly 20 years.

        I have often wondered if high intensity exercise is actually beneficial for MS. One of the side-effects of hard training is a decline in the immune system. From my perspective, this would seem like a win-win: I get stronger, have better endurance, better coordination, stay mentally sharp (yes, exercise does that, too!), and possibly inhibit my MS.

        All I know now is that I have to find the right motivator to get me off my relative couch... I will add as full disclaimer that training for an Ironman, even half-assed with the goal not to race, but to participate (the only other time with that goal was my first IM in 1995), generally decreases the desire to train at all once finally finished.

        5k racing, anyone?

        -Chris Ramsey
        Last edited by MS-vs-MS; 06-20-2014, 10:13 AM. Reason: add signature
        Chris Ramsey - PT, DPT, OCS
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