The Safety of Exercise Training in Multiple Sclerosis: A Systematic Review
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 risks of relapse and 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 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.
27 studies with 1,330 participants were included. We determined the rate of relapse was 6.0% and 4.5% for control and exercise, respectively. The rate of AEs was 1.1% and 1.9% for control and exercise, respectively. The relative risk of relapse for exercise training was 0.75, whereas the relative risk of AE for exercise training was 1.73.
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.