Impact of Physical Activity Guidelines on Quality of Life in Multiple Sclerosis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Document Type

Article

Publication Title

International Journal of MS Care

Abstract

Background: Physical activity is well supported as an effective intervention with numerous benefits for people with multiple sclerosis (MS). Recent research has suggested stronger physical activity guidelines for people with MS (PAG-MS). This systematic review and meta-analysis aims to assess the impact of PAG-MS on quality of life (QOL). A secondary aim is the assessment of the number of adverse effects across studies to gauge physical activity safety in people with MS.

Methods: A systematic search was conducted from inception to October 2024 in PubMed, Embase, Web of Science, SPORTDiscus, Scopus, and PsycINFO. Two independent reviewers assessed included studies for eligibility, extracted data, and evaluated risk of bias using the Cochrane Revised Tool for Risk of Bias in Randomized Trials. Randomized controlled trials assessing QOL with an intervention meeting PAG-MS were included. Extracted data were analyzed via meta-analysis and compared with clinical significance thresholds where possible.

Results: Nineteen studies including 891 people with MS were identified. Meta-analysis revealed significant increases in overall QOL (standardized mean difference [MD], 1.13; 95% CI, 0.40-1.86; P < .01) as well as physical (MD, 12.84; 95% CI, 5.29-20.39; P < .01) and mental (MD, 16.75; 95% CI, 11.9-21.59; P = .04) subscale scores. Physical and mental subscale scores surpassed clinical significance thresholds. The majority of studies were rated to have a high risk of bias.

Conclusions: The current PAG-MS appear to be effective in improving QOL in people with MS. Multiple forms of physical activity that met the PAG-MS demonstrated comparable efficacy, supporting the feasibility of individualized physical activity prescriptions based on patient-specific needs and preferences.

DOI

10.7224/1537-2073.2025-057

Publication Date

4-13-2026

Keywords

quality of life, physical activity, guidelines, exercise

ISSN

2834-5398

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