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The effect of exercise on cognitive function in people with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials

Journal

JOURNAL OF NEUROLOGY
Volume 270, Issue 6, Pages 2908-2923

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00415-023-11649-7

Keywords

Exercise; Cognitive function; Multiple sclerosis; Systematic review; Meta-analysis

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Through a systematic review and meta-analysis, it was found that exercise has a significant improvement on cognitive function in patients with multiple sclerosis (MS), especially in memory function. It is recommended that MS patients participate in at least three multicomponent training sessions per week, with each session lasting up to 60 minutes, and achieve a weekly exercise goal of 180 minutes. Exercise lasting 8 or 10 weeks has the best improvement on cognitive function. Furthermore, patients with a worse basal MS status or older age have a greater effect on cognitive function.
ObjectiveA growing body of research examining the effect of exercise on cognitive function in people with multiple sclerosis (MS), while findings of available studies were conflicting. We aimed to explore the effect of exercise on cognitive function in MS patients.MethodsFor this systematic review and meta-analysis, we searched PubMed, Web of Science, EBSCO, Cochrane, and Scopus electronic databases, through July 18, 2022. Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature.ResultsTwenty-one studies with a total of 23 experimental groups and 21 control groups met the inclusion criteria. There was a significant effect of exercise on improving cognitive function in MS patients, while the effect size was small (Cohen's d = 0.20, 95% CI 0.06-0.34, p < 0.001, I-2 = 39.31%). Subgroup analysis showed that exercise significantly improved memory (Cohen's d = 0.17, 95% CI 0.02-0.33, p = 0.03, I-2 = 7.59%). In addition, multicomponent training, exercise conducted 8 weeks and 10 weeks, up to 60 min per session, 3 times or more per week, 180 min or more per week increased cognitive function significantly. Furthermore, a worse basal MS status (defined by the Expanded Disability Status Scale) and an older age were associated with greater improvement in cognitive function.ConclusionMS patients are recommended to participate in at least three multicomponent training sessions per week, with each session lasting up to 60 min, and the exercise goal of 180 min per week can be achieved by increasing the frequency of exercise. Exercise lasting 8 or 10 weeks is best for cognitive function improvement. Additionally, a worse basal MS status, or the older the age, the greater effect on cognitive function.

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