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Aerobic and resistance exercise improve walking speed and endurance in people with multiple sclerosis (commentary)
Robert Motl
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, USA
Walking dysfunction is a common, life-altering feature of multiple sclerosis. Accordingly, the improvement of walking function is a major focus of ongoing rehabilitation research. Physiological deconditioning (eg, aerobic capacity) is a primary determinant of walking dysfunction in multiple sclerosis,1 and exercise represents a behavioural approach for reversing deconditioning and thereby improving ambulation. The meta-analysis by Pearson and colleagues quantified the improvement in walking performance across randomised, controlled trials of exercise in multiple sclerosis. The meta-analysis included 13 trials and suggested that exercise can improve walking speed, walking endurance, and perhaps mobility (eg, Timed Up and Go test) in people with multiple sclerosis.
This meta-analysis did not consider disease status or fitness adaptations as effect moderators. This is important for understanding if exercise is effective across the disease spectrum, particularly considering that drugs are ineffective for slowing eventual progression of mobility disability in moderate and severe multiple sclerosis.2 The focus on fitness would provide information on changes in physiological functioning as possible mechanisms for walking improvements.
Overall, this meta-analysis provides estimates of exercise effects on walking outcomes in multiple sclerosis. The results can inform power analyses for future randomised, controlled trials and inform clinical practice recommendations. Clinically, exercise is a considerably less expensive option for managing walking outcomes in multiple sclerosis than pharmacotherapy and can be prescribed as part of ongoing, comprehensive multiple sclerosis care. There are many benefits of exercise in multiple sclerosis, and this meta-analysis further underscores its importance for comprehensively improving outcomes, including walking, in this neurological disease.
Robert Motl
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, USA
Walking dysfunction is a common, life-altering feature of multiple sclerosis. Accordingly, the improvement of walking function is a major focus of ongoing rehabilitation research. Physiological deconditioning (eg, aerobic capacity) is a primary determinant of walking dysfunction in multiple sclerosis,1 and exercise represents a behavioural approach for reversing deconditioning and thereby improving ambulation. The meta-analysis by Pearson and colleagues quantified the improvement in walking performance across randomised, controlled trials of exercise in multiple sclerosis. The meta-analysis included 13 trials and suggested that exercise can improve walking speed, walking endurance, and perhaps mobility (eg, Timed Up and Go test) in people with multiple sclerosis.
This meta-analysis did not consider disease status or fitness adaptations as effect moderators. This is important for understanding if exercise is effective across the disease spectrum, particularly considering that drugs are ineffective for slowing eventual progression of mobility disability in moderate and severe multiple sclerosis.2 The focus on fitness would provide information on changes in physiological functioning as possible mechanisms for walking improvements.
Overall, this meta-analysis provides estimates of exercise effects on walking outcomes in multiple sclerosis. The results can inform power analyses for future randomised, controlled trials and inform clinical practice recommendations. Clinically, exercise is a considerably less expensive option for managing walking outcomes in multiple sclerosis than pharmacotherapy and can be prescribed as part of ongoing, comprehensive multiple sclerosis care. There are many benefits of exercise in multiple sclerosis, and this meta-analysis further underscores its importance for comprehensively improving outcomes, including walking, in this neurological disease.