Physical exercise in multiple sclerosis: supportive care or a putative disease-modifying treatment

Area of Science:

• Neurology
• Rehabilitation Medicine
• Exercise Physiology

Background:

• Multiple sclerosis (MS) is a chronic neuroinflammatory and neurodegenerative disease impacting young adults, often leading to significant disability.
• Historically, physical activity was discouraged for MS patients, but recent evidence suggests otherwise.
• Emerging research indicates exercise training positively impacts fitness, quality of life, and functional measures in MS.

Purpose of the Study:

• To review major clinical trials investigating the effects of exercise training in multiple sclerosis.
• To discuss potential biological mechanisms mediating exercise benefits in MS, including neurotrophic factors and anti-inflammatory cytokines.
• To propose evidence-based exercise management guidelines and outline future research strategies for exercise in MS.

Main Methods:

• Systematic review of major clinical trials on exercise interventions in multiple sclerosis.
• Analysis of studies examining the impact of exercise on fitness parameters, quality of life, and disability measures in MS patients.
• Exploration of research on biological mediators, such as neurotrophic factors and cytokines, influenced by exercise in MS.

Main Results:

• Exercise training demonstrably improves fitness parameters in individuals with MS.
• Significant enhancements in quality of life and positive effects on disability measures are associated with exercise programs.
• Pilot studies suggest a potential neuroprotective role for exercise in the context of MS.

Conclusions:

• Exercise training is a beneficial intervention for multiple sclerosis, improving multiple health outcomes.
• Understanding the biological mechanisms underlying exercise benefits can refine therapeutic strategies.
• Evidence supports the development of specific exercise guidelines and further research to optimize exercise prescription for MS patients.