Autonomic, pulmonary and cardiovascular function at rest and during physical exercise in people with multiple...

The purpose of the present review was to determine the extent of autonomic dysfunction as well as pulmonary and cardiovascular impairments at rest and during physical exercise in people with multiple sclerosis (pwMS) compared to healthy controls.

A comprehensive literature review was conducted using PubMed and Embase databases. Relevant absolute mean±SD values, along with sample sizes for pwMS and healthy controls, were extracted in addition to selected participant characteristics and test conditions. Further quantitative analyses were conducted using Cohen's d for effect size (ES) via standardized mean difference (ES_SMD) and absolute mean difference (ES_SMD). The Cochrane Q test was quantified by I² statistics for heterogeneity. Sensitivity analyses were performed to assess the robustness of results.

The literature search yielded 1323 results, of which 45 were included in the meta-analysis. Data analyses revealed substantial autonomic dysfunction in addition to substantially impaired pulmonary and cardiovascular function, both at rest and during exercise in pwMS when compared to healthy controls. The findings suggested that autonomic dysfunction in pwMS consists of decreased parasympathetic activity and sympathetic hypo-reactivity. Results further indicated that reduced pulmonary and cardiovascular function may, in part, be attributed to autonomic dysfunction in addition to physical deconditioning in pwMS.

pwMS exhibits substantial autonomic dysfunction compared to healthy controls. In addition, pwMS present pulmonary and cardiovascular impairments both during resting and exercising conditions. The present review highlights important impairments that should be considered in the clinical management of pwMS.