Physical activity and cognitive function in adults with multiple sclerosis: an integrative review

Abstract

Purpose: To identify and synthesize the research evidence concerning (1) the relationship between physical activity and cognitive performance in persons with multiple sclerosis (MS) and (2) to review the reported effects of physical activity interventions on neurocognitive performance conducted in this population.

Methods: Relevant peer-reviewed journal articles were identified by searching PubMed, PsychINFO, and SPORTDiscus through May 2016. Full-text articles meeting the inclusion criteria were evaluated for quality using tools developed by the National Institutes of Health. Studies deemed to be of poor quality were excluded from the review.

Results: Nineteen studies meeting the inclusion/exclusion criteria were analyzed. Nine studies reported significant relationships between higher levels of physical activity or cardiorespiratory fitness and measures of cognitive function. Data extracted from 10 physical activity intervention studies reported mixed results on the effectiveness of physical activity to improve selected domains of cognitive function in persons with MS.

Conclusion: Although correlational studies provide evidence to support a linkage between physical activity and cognitive function in persons with MS, this linkage is confounded by factors that may have influenced the studies’ results. Evidence derived from intervention studies that could support a positive effect of physical activity on cognition in persons with MS is equivocal.

Implications for Rehabilitation

• Physical activity has numerous benefits for persons with multiple sclerosis (MS) including improvements in balance, ambulation, depression, fatigue, and quality of life.

• Structured physical activity programs may contribute to cognitive function stability or improvement in persons with MS.

Keywords:

• Multiple sclerosis
• cognition
• cognitive function
• exercise
• physical activity
• review

Acknowledgements

Special thanks to Dr. Alexa Stuifbergen, Dr. Heather Becker, and Dr. Sharon Brown for their guidance, support, and encouragement.

Disclosure statement

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. JDM reports no conflicts of interest. LM has received compensation for speaking or consulting for Sanofi Genzyme, Novartis Pharmaceuticals, Teva Neuroscience, Biogen Idec, Genentech, EMD Serono, and TG Therapeutics.

Funding

This research was supported by grants from the International Organization of Multiple Sclerosis Nurses and the National Institute of Nursing Research of the National Institutes of Health (F31 NR014601).