The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis

Introduction: Multiple sclerosis (MS) is a chronic autoimmune disease affecting the myelinated axons of the central nervous system causing neurological deterioration. People living with MS have a poor quality of life (QOL) because of the symptoms caused by the disease and there are various types of treatments to manage the symptoms aside from medication. Objective: This meta-analysis examines the effect of exercise, yoga and physiotherapy on the physical, mental and social QOL among individuals living with MS. Setting: A systematic review with meta-analysis was conducted using PubMed, Medline, and Scopus from 1990 to 2017. The standard mean difference scores were computed in each study for the domains of physical, mental and social functioning. Results: Eighteen studies met the inclusion criteria for this meta-analysis. Aerobic exercise was effective in improving satisfaction with physical functioning,d = 0.35 (95% CI = 0.08 to 0.62), mental functioning d = 0.42 (95% CI = 0.11 to 0.72), and social functioning d = 0.42 (95% CI = 0.15 to 0.69). Physiotherapy was also found to be effective for physical functioning d = 0.50 (95% CI 0.19 to 0.80), mental functioning d = 0.44 (95% CI 0.14 to 0.75) and social functioning d = 0.60 (95% CI 0.21 to 0.90). However yoga and combination of exercises did not have a significant effect on any of the QOL domains. Conclusion: These findings suggest that aerobic exercise and physiotherapy improves the satisfaction of MS patients with their physical, mental and social functioning and may be included as normal practice in the treatment of MS.