Reza Gharakhanlou1, Leonie Wesselmann2, Annette Rademacher2, Amit Lampit3, Raoof Negaresh1, Mojtaba Kaviani4, Max Oberste2, Robert W Motl5, Brian M Sandroff5, Jens Bansi6, Julien S Baker7, Christoph Heesen8, Philipp Zimmer9, Florian Javelle2. 1. Department of Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran. 2. Clinical Exercise-Neuroimmunology Group, Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany. 3. Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany. 4. School of Nutrition and Dietetics, Acadia University, Wolfville, NS, Canada. 5. Department of Physical Therapy, The University of Alabama at Birmingham, Birmingham, AL, USA. 6. Department of Neurology, Kliniken-Valens, Rehabilitationsklinik-Valens, Valens, Switzerland. 7. Institute for Clinical Exercise and Health Science, School of Science and Sport, University of the West of Scotland, Hamilton, UK. 8. Institute of Neuroimmunology and Multiple Sclerosis, Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 9. Clinical Exercise-Neuroimmunology Group, Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany/Department for Performance and Health (Sports Medicine), Institute for Sport and Sport Science, Technical University Dortmund, Dortmund, Germany.
Abstract
BACKGROUND: Cognitive impairment is common, debilitating, and poorly managed in persons with multiple sclerosis (pwMS). Exercise training might have positive effects on cognitive performance in pwMS, yet the overall magnitude, heterogeneity, and potential moderators remain unclear. OBJECTIVE: This three-level meta-analysis aims to identify the effects of exercise training and those of exercise modalities on global and domain-specific cognitive performance in pwMS. METHODS: MEDLINE, PsycInfo, SportDiscus, CENTRAL, and EMBASE were screened for randomized and non-randomized clinical trials from inception to 27 January 2020, yielding 3091 articles. Based on titles and abstracts, 75 articles remained in the selection process. After full-text evaluation, 13 studies were finally selected (PROSPERO pre-registered). RESULTS: The pooled effect of exercise training on the global cognitive performance was null (g = 0.04, 95% confidence interval (CI): -0.11 to 0.18) and no significant differences were displayed among domains. Heterogeneity within studies was null (I(2)2= 0.0%) and between studies was low (I(3)2= 25.1%). None of the moderators (exercise modalities, age, Expanded Disability Status Scale (EDSS), supervision, cognitive domains) reached significance. However, the exercise volume explained most of the overall heterogeneity (slope = 4.651 × 10-5, R(2)2 = 100%, R(3)2 = 52.34%). CONCLUSION: These results do not support the efficacy of exercise training on global or domain-specific cognitive performance in pwMS. Future studies are needed to determine whether higher training dose are beneficial.
BACKGROUND: Cognitive impairment is common, debilitating, and poorly managed in persons with multiple sclerosis (pwMS). Exercise training might have positive effects on cognitive performance in pwMS, yet the overall magnitude, heterogeneity, and potential moderators remain unclear. OBJECTIVE: This three-level meta-analysis aims to identify the effects of exercise training and those of exercise modalities on global and domain-specific cognitive performance in pwMS. METHODS: MEDLINE, PsycInfo, SportDiscus, CENTRAL, and EMBASE were screened for randomized and non-randomized clinical trials from inception to 27 January 2020, yielding 3091 articles. Based on titles and abstracts, 75 articles remained in the selection process. After full-text evaluation, 13 studies were finally selected (PROSPERO pre-registered). RESULTS: The pooled effect of exercise training on the global cognitive performance was null (g = 0.04, 95% confidence interval (CI): -0.11 to 0.18) and no significant differences were displayed among domains. Heterogeneity within studies was null (I(2)2= 0.0%) and between studies was low (I(3)2= 25.1%). None of the moderators (exercise modalities, age, Expanded Disability Status Scale (EDSS), supervision, cognitive domains) reached significance. However, the exercise volume explained most of the overall heterogeneity (slope = 4.651 × 10-5, R(2)2 = 100%, R(3)2 = 52.34%). CONCLUSION: These results do not support the efficacy of exercise training on global or domain-specific cognitive performance in pwMS. Future studies are needed to determine whether higher training dose are beneficial.
Authors: Annette Rademacher; Niklas Joisten; Sebastian Proschinger; Wilhelm Bloch; Roman Gonzenbach; Jan Kool; Dawn Langdon; Jens Bansi; Philipp Zimmer Journal: Front Neurol Date: 2021-01-28 Impact factor: 4.003
Authors: Inga Heinrich; Friederike Rosenthal; Stefan Patra; Karl-Heinz Schulz; Götz H Welsch; Eik Vettorazzi; Sina C Rosenkranz; Jan Patrick Stellmann; Caren Ramien; Jana Pöttgen; Stefan M Gold; Christoph Heesen Journal: Front Neurol Date: 2021-07-19 Impact factor: 4.003