A Meta-Analytic and Scoping Study on Strength Training in People with Multiple Sclerosis

Aim of the study was to determine a pooled estimate of effect on muscle strength and functional capacity induced by strength training in people with multiple sclerosis (PwMS).
Five databases and 2 public registries were searched from inception to May 2017. Indexing terms employed were: “multiple sclerosis”, “resistance training” and “strength training”.
Following title/abstract screening, two independent reviewers evaluated the studies’ eligibility, which were retained if PwMS were randomly assigned to strength training or to a no-intervention group. Of the 1467 items retrieved, 30 randomized controlled trials (RCTs) formed the initial database with 11 trials (426 subjects) entering the final meta-analysis.
The quality of the included studies was assessed by the PEDro scale and the risk of bias using the Cochrane Risk-of-Bias tool. All meta-analyses were conducted using a random-effects model.
Following interventions PwMS increased strength by 23.1% (CI 11.8-34.4; +12.1 N; CI 4.5-19.8; p=0.002; n= 366 subjects) at a small to moderate effect size (0.37; CI 0.2-0.6). Walking speed increased by 16.3±10.7% (p=0.0002; effect size 0.54; n=275 subjects), distance covered in the 2-Minute Walking Test by 6.7±6.4% (p=0.04; effect size 0.50; n=111 subjects.
PwMS respond to resistance training with consistent strength gains. Methodological inconsistencies among studies and inadequate reporting of the findings limited a comprehensive determination of the impact of strength improvements on patient functioning, except for walking performance which appeared significantly improved. Methodological steps and scoping lines are provided to establish a common platform for future trials.