Exploring Wellness-Based Interventions in People with Multiple Sclerosis: An Evidence-Based Review

Background: There has been recent increased interest in the role of lifestyle and wellness-based approaches in the treatment and management of multiple sclerosis (MS). These approaches may be particularly relevant for persons with progressive MS, considering the limited therapeutic options currently available.

Objectives: The purpose of this scoping review was to examine the role of wellness-based interventions (i.e., exercise training, emotional well-being therapies, and dietary modification) in persons with progressive forms of MS.

Methods: We conducted a literature search on the efficacy of wellness-based interventions in persons with progressive forms of MS published between 1985 and July 2017. The level of evidence for each trial was evaluated using the American Academy of Neurology criteria. Overall, 21 articles reporting on 16 wellness-based interventions were identified: ten trials involved exercise training, three involved emotional wellness therapies, two involved dietary modification, and one was a combined wellness intervention.

Results: There is level C evidence (possibly effective; one Class II study) for the efficacy of aerobic exercise training on cardiorespiratory fitness in persons with progressive MS. There is level B evidence (probably effective; one Class I study) for the efficacy of mindfulness-based training on psychological distress, depression, anxiety, pain, and quality of life in persons with progressive forms of MS. There is inadequate evidence (level U) for the efficacy of dietary modification (one Class III study and one Class IV study) and combined wellness interventions involving exercise training, meditation, and dietary modification (one Class IV study).

Conclusions: High-quality research is necessary to provide evidence-based recommendations for wellness-based interventions for persons with progressive forms of MS.