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Best practice exercise for emerging depression in multiple sclerosis: A systematic review and meta-analysis

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dc.contributor.authorAhola, K.
dc.contributor.authorDorstyn, D.
dc.contributor.authorPrideaux, N.
dc.date.issued2024
dc.description.abstractObjective: To examine the effects of instructor-led exercise on depression symptoms in adults with multiple sclerosis, with a focus on moderating factors to treatment response. Data sources: Cochrane Library, Embase, PEDro, PsycINFO and PubMed databases were searched until 21 April 2024. Review methods: The reporting quality of included studies assessed (PEDro and TESTEX scales). Hedges’ g effect sizes were calculated and pooled using random and mixed-effects modelling. Results: Twenty-two independent studies (k), representing 785 participants with relapsing remitting or progressive MS, were included. Individual studies varied in their reporting quality (PEDro range: 3–8) and did not routinely detail exercise parameters (TESTEX range: 5–13). Nonetheless, exercise reduced core symptoms of depression (gw=.52, CI: .30–.73, P < .01). Treatment effects were, however, not maintained once training had ceased (gw=−.53, CI: −.80 to .24, P ≤.01, k=5). Both aerobic and non-aerobic exercise groups experienced a significant (P < .01) reduction in depression scores. Larger gains were noted by those with better ambulation at baseline (P =.03). Conclusion: Regular exercise can help to stabilise mood for people living with multiple sclerosis, regardless of session frequency or duration. Treatment efficacy could be maximised by addressing potential barriers for those with limited mobility, including exercise type, delivery and intensity. Protocol registered on Open Science Framework [https://osf.io/zfymq/].
dc.description.statementofresponsibilityKristiina Ahola, Diana Dorstyn and Nicole Prideaux
dc.identifier.citationClinical Rehabilitation, 2024; 38(9):1171-1187
dc.identifier.doi10.1177/02692155241262884
dc.identifier.issn0269-2155
dc.identifier.issn1477-0873
dc.identifier.orcidDorstyn, D. [0000-0002-7799-8177]
dc.identifier.orcidPrideaux, N. [0000-0001-7673-7621]
dc.identifier.urihttps://hdl.handle.net/2440/143104
dc.language.isoen
dc.publisherSAGE Publications
dc.rights© The Author(s) 2024. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
dc.source.urihttp://dx.doi.org/10.1177/02692155241262884
dc.subjectdepression
dc.subjectMultiple sclerosis
dc.subjectrehabilitation
dc.subjectsystematic review
dc.titleBest practice exercise for emerging depression in multiple sclerosis: A systematic review and meta-analysis
dc.typeJournal article
pubs.publication-statusPublished online

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