A team of experts has encouraged ongoing investigation into the benefits of physical training for people with multiple sclerosis, citing shortcomings in available studies. They described their perspectives for this line of research in “Exercise in multiple sclerosis”, published in Lancet April 20, 2022. (doi: 10.1016/S1474-4422(22)00045-X.)
The authors are Brian Sandroff, PhD, of the Kessler Foundation, Robert W. Motl, PhD, of the University of Illinois at Chicago, V. Wee Yong, PhD, of the University of Calgary in Canada, Gary R Cutter , PhD, from the University of Alabama at Birmingham, and Gavin Giovannoni, MD, from Queen Mary University of London, Barts and the London School of Medicine and Dentistry in the UK.
The team members contradicted the findings of recent reviews, which indicated that exercise training is not associated with neuroprotection in people with multiple sclerosis. Evidence suggests that exercise can prevent or reverse existing and measurable neurological damage or decline, the team members said. They also suggest that the available studies are few and poorly designed and should not discourage ongoing research in this promising area.
Shortcomings cited by the team include patient selection (lack of measurable and pre-existing central nervous system damage), design of exercise regimens (too short duration of training/monitoring protocols), lack of a priori neurophysiological hypotheses (failure to take into account cerebral adaptations and regions of interest for neuroprotection) and selection of neuroimaging techniques (excessive use of whole/structural brain neuroimaging).
Gaps in existing research prevent strong conclusions from being drawn at this time. Only through rigorous study can we explore the promise of neuroprotection for people with multiple sclerosis.”
Dr. Sandroff, Senior Author, Principal Investigator, Center for Neuropsychology and Neuroscience, Kessler Foundation
“The advancement of this line of research depends on well-designed, randomized, controlled trials based on our knowledge of exercise-induced focal neuroprotection, with targeted selection criteria, adequate training and follow-up durations, and appropriate neuroimaging techniques,” he concluded. “This will form the future evidence base for evaluating the role of physical training in the management of multiple sclerosis. As an approach that offers low cost, easy access and few side effects, the potential benefits of exercise for people with multiple sclerosis warrant further investigation.”
Sandroff, BM, et al. (2022) Exercise in Multiple Sclerosis. The Lancet. doi.org/10.1016/S1474-4422(22)00045-X.