Effects and optimal dosage of resistance training on strength, functional capacity, balance, general health perception, and fatigue in people with multiple sclerosis: a systematic review and meta-analysis

Abstract

Purpose

To analyze the effectiveness of resistance training programs (RTP) on strength, functional capacity, balance, general health perception, and fatigue for people with Multiple Sclerosis (MS) and to determine the most effective dose of RTP in this population.

Methods

Studies examining the effect of RTP on strength, functional capacity, balance, general health perception, and fatigue in MS patients were included. 44 studies were included. The meta-analysis, subgroup analysis and meta-regression methods were used to calculate the mean difference and standardized mean difference.

Results

Significant group differences were observed in knee extensor (p = 0.01) and flexor (p < 0.001), but not in 1-repetition maximum. Regarding functional capacity and balance, differences between groups, in favour of the RTP group, were found in the Timed Up and Go Test (p = 0.001), walking endurance, (p = 0.02) gait speed (p = 0.02) and balance (p = 0.02). No significant differences between groups were observed in fatigue or general health perception. The results regarding the optimal dose are inconsistent.

Conclusions

RTP improves strength, functional capacity, balance, and fatigue in people with MS. Registration: (PROSPERO): CRD42020182781

Implications for rehabilitation

• Resistance training is a valid strategy to improve isometric strength and functional capacity in MS patients.

• RTP using long durations (more than 6 weeks), high intensity (more than 80% 1-RM) and two-day weekly training frequency may be a correct stimulus to improve strength, functional capacity, balance, and fatigue in people with MS.

• Trainers and rehabilitators should consider these indicators in order to maximize muscular and functional adaptations in this population.

Keywords:

• Resistance training
• neurological disorder
• exercise
• nervous system diseases

Author contributions

LAC and JARA. conceived of the presented idea. LAC wrote the manuscript with support from JARA. JARA, DJRC, AMR and LHC supervised the work. All authors discussed the results and contributed to the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work has been supported partially by the Spanish Ministry of Education, Culture and Science through the National Program FPU.