Review article (meta-analysis)| Volume 97, ISSUE 9, P1564-1572, September 2016

Effect of Exercise Training on Fitness in Multiple Sclerosis: A Meta-Analysis

Published:February 16, 2016DOI:



      To provide a quantitative synthesis of randomized controlled trials (RCTs) examining the effect of exercise training on muscular and cardiorespiratory fitness in persons with multiple sclerosis (MS).

      Data Sources

      Three electronic databases, PubMed, Google Scholar, and Web of Science, were searched for all relevant articles published up until October 2014.

      Study Selection

      Keywords included exercise or aerobic or strength or resistance training or cardiorespiratory and multiple sclerosis. Trials examining the effect of exercise training on muscular and/or cardiorespiratory fitness parameters were included.

      Data Extraction

      The initial search yielded 1501 articles; of these, 62 were reviewed in detail, and 20 RCTs met the inclusion criteria and provided enough data to compute effect sizes (ESs) (Cohen d). The meta-analyses was conducted using a random effects model to compute the overall or mean ES per fitness parameter.

      Data Synthesis

      The mean ES was .27 (SE=.05; 95% confidence interval [CI], .17–.38; z=5.05; P<.001) for muscular fitness outcomes and .47 (SE=.09; 95% CI, .30–.65; z=5.4; P<.001) for cardiorespiratory fitness outcomes. The weighted mean ES was not heterogeneous for muscular (Q13=11.09, P=.60, I2=.00) or cardiorespiratory (Q9=7.83, P=.55, I2=.00) fitness outcomes.


      The cumulative evidence supports that exercise training is associated with changes in muscular (small in magnitude) and cardiorespiratory (moderate in magnitude) fitness outcomes in persons with MS. Such an indication of magnitude is important for clinical research and practice by providing an evidence-based estimate of the actual benefit that exercise training confers on physiological fitness.


      List of abbreviations:

      CI (confidence interval), ES (effect size), MS (multiple sclerosis), PEDro (Physiotherapy Evidence Database), RCT (randomized controlled trial), Vo2peak (peak oxygen consumption)
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