title: Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development.
abstract: OBJECTIVE
  To conduct a systematic review of evidence surrounding the effects of exercise training on physical fitness, mobility, fatigue, and health-related quality of life in adults with multiple sclerosis (MS).
  
  
  METHODS
  The databases included EMBASE, 1980 to 2011 (wk 12); Ovid MEDLINE and Ovid OLDMEDLINE, 1947 to March (wk 3) 2011; PsycINFO, 1967 to March (wk 4) 2011; CINAHL all-inclusive; SPORTDiscus all-inclusive; Cochrane Library all-inclusive; and Physiotherapy Evidence Database all-inclusive.
  
  
  METHODS
  The review was limited to English-language studies (published before December 2011) of people with MS that evaluated the effects of exercise training on outcomes of physical fitness, mobility, fatigue, and/or health-related quality of life.
  
  
  METHODS
  One research assistant extracted data and rated study quality. A second research assistant verified the extraction and quality assessment.
  
  
  RESULTS
  From the 4362 studies identified, 54 studies were included in the review. The extracted data were analyzed using a descriptive approach. There was strong evidence that exercise performed 2 times per week at a moderate intensity increases aerobic capacity and muscular strength. The evidence was not consistent regarding the effects of exercise training on other outcomes.
  
  
  CONCLUSIONS
  Among those with mild to moderate disability from MS, there is sufficient evidence that exercise training is effective for improving both aerobic capacity and muscular strength. Exercise may improve mobility, fatigue, and health-related quality of life.
authors.affiliation: School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada. amy.latimer@queensu.ca
authors.forename: Amy E
authors.initials: AE
authors.lastname: Latimer-Cheung
authors.forename: Lara A
authors.initials: LA
authors.lastname: Pilutti
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Hicks
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Martin Ginis
authors.forename: Alyssa M
authors.initials: AM
authors.lastname: Fenuta
authors.forename: K Ann
authors.initials: KA
authors.lastname: MacKibbon
authors.forename: Robert W
authors.initials: RW
authors.lastname: Motl
mesh_terms: D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000503:physiopathology*; D006801:Humans; D051346:Mobility Limitation; D009103:Multiple Sclerosis / Q000523:psychology / Q000534:rehabilitation*; D010809:Physical Fitness / Q000502:physiology*; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D016138:Walking / Q000502:physiology
keywords: EDSS; Exercise; Expanded Disability Status Scale; FES; Guideline; HRQOL; MS; Multiple sclerosis; PEDro; Physical fitness; Physiotherapy Evidence Database; RCT; RM; Rehabilitation; functional electrical stimulation; health-related quality of life; maximal oxygen consumption; multiple sclerosis; o(2)max; randomized controlled trial; repetition maximum