TY - JOUR
T1 - Exercise training and cognitive performance in persons with multiple sclerosis
T2 - A systematic review and multilevel meta-analysis of clinical trials
AU - Gharakhanlou, Reza
AU - Wesselmann, Leonie
AU - Rademacher, Annette
AU - Lampit, Amit
AU - Negaresh, Raoof
AU - Kaviani, Mojtaba
AU - Oberste, Max
AU - Motl, Robert W.
AU - Sandroff, Brian M.
AU - Bansi, Jens
AU - Baker, Julien
AU - Heesen, Christoph
AU - Zimmer, Philipp
AU - Javelle, Florian
N1 - Funding Information:
The authors want to thank Alan Metcalfe for the English proof reading, Sylvain Laborde for his suggestions, Lina Brummel for her help in the data search, and Stephan Krohn for assistance with data analysis. The author(s) received no financial support for the research, authorship, and/or publication of this article.
Publisher Copyright:
© The Author(s), 2020.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Background: Cognitive impairment is common, debilitating, and poorly managed in persons with multiple sclerosis (pwMS). Exercise training might have positive effects on cognitive performance in pwMS, yet the overall magnitude, heterogeneity, and potential moderators remain unclear. Objective: This three-level meta-analysis aims to identify the effects of exercise training and those of exercise modalities on global and domain-specific cognitive performance in pwMS. Methods: MEDLINE, PsycInfo, SportDiscus, CENTRAL, and EMBASE were screened for randomized and non-randomized clinical trials from inception to 27 January 2020, yielding 3091 articles. Based on titles and abstracts, 75 articles remained in the selection process. After full-text evaluation, 13 studies were finally selected (PROSPERO pre-registered). Results: The pooled effect of exercise training on the global cognitive performance was null (g = 0.04, 95% confidence interval (CI): –0.11 to 0.18) and no significant differences were displayed among domains. Heterogeneity within studies was null ((Formula presented.) = 0.0%) and between studies was low ((Formula presented.) = 25.1%). None of the moderators (exercise modalities, age, Expanded Disability Status Scale (EDSS), supervision, cognitive domains) reached significance. However, the exercise volume explained most of the overall heterogeneity (slope = 4.651 × 10−5, (Formula presented.) = 100%, (Formula presented.) = 52.34%). Conclusion: These results do not support the efficacy of exercise training on global or domain-specific cognitive performance in pwMS. Future studies are needed to determine whether higher training dose are beneficial.
AB - Background: Cognitive impairment is common, debilitating, and poorly managed in persons with multiple sclerosis (pwMS). Exercise training might have positive effects on cognitive performance in pwMS, yet the overall magnitude, heterogeneity, and potential moderators remain unclear. Objective: This three-level meta-analysis aims to identify the effects of exercise training and those of exercise modalities on global and domain-specific cognitive performance in pwMS. Methods: MEDLINE, PsycInfo, SportDiscus, CENTRAL, and EMBASE were screened for randomized and non-randomized clinical trials from inception to 27 January 2020, yielding 3091 articles. Based on titles and abstracts, 75 articles remained in the selection process. After full-text evaluation, 13 studies were finally selected (PROSPERO pre-registered). Results: The pooled effect of exercise training on the global cognitive performance was null (g = 0.04, 95% confidence interval (CI): –0.11 to 0.18) and no significant differences were displayed among domains. Heterogeneity within studies was null ((Formula presented.) = 0.0%) and between studies was low ((Formula presented.) = 25.1%). None of the moderators (exercise modalities, age, Expanded Disability Status Scale (EDSS), supervision, cognitive domains) reached significance. However, the exercise volume explained most of the overall heterogeneity (slope = 4.651 × 10−5, (Formula presented.) = 100%, (Formula presented.) = 52.34%). Conclusion: These results do not support the efficacy of exercise training on global or domain-specific cognitive performance in pwMS. Future studies are needed to determine whether higher training dose are beneficial.
KW - cognition
KW - exercise volume
KW - meta-analysis
KW - moderators
KW - Multiple sclerosis
KW - physical exercise
UR - http://www.scopus.com/inward/record.url?scp=85084744968&partnerID=8YFLogxK
U2 - 10.1177/1352458520917935
DO - 10.1177/1352458520917935
M3 - Article
C2 - 32390502
AN - SCOPUS:85084744968
SN - 1352-4585
VL - 27
SP - 1977
EP - 1993
JO - Multiple Sclerosis Journal
JF - Multiple Sclerosis Journal
IS - 13
ER -