title: Exercise as a therapy for improvement of walking ability in adults with multiple sclerosis: a meta-analysis.
abstract: OBJECTIVE
  To quantify improvements in walking performance commonly observed in patients with multiple sclerosis (pwMS), a systematic literature search and meta-analysis were conducted quantifying the expected benefits of exercise on walking ability in pwMS.
  
  
  METHODS
  Potential studies were identified by systematic search using PubMed (1966 to March 31, 2014), EMBASE (1974 to March 31, 2014), CINAHL (1998 to March 31, 2014), SPORTDiscus (1991 to March 31, 2014), and the Cochrane Central Register of Controlled Trials (1966 to March 31, 2014). The search used key concepts of "multiple sclerosis" AND "exercise."
  
  
  METHODS
  Randomized controlled trials of exercise training in adult pwMS.
  
  
  METHODS
  Data on patient and study characteristics, walking ability, 10-m walk test (10mWT), timed 25-foot walk test (T25FW), 2-minute walk test (2MWT), 6-minute walk test (6MWT), and timed Up and Go (TUG) were extracted and archived.
  
  
  RESULTS
  Data from 13 studies were included. In pwMS who exercised, significant improvements were found in walking speed, measured by the 10mWT (mean difference [MD] reduction in walking time of -1.76s; 95% confidence interval [CI], -2.47 to -1.06; P<.001), but no change in the T25FW (MD=-.59s; 95% CI, -2.55 to 1.36; P=.55). In pwMS who exercised, significant improvements were found in walking endurance as measured by the 6MWT and 2MWT, with an increased walking distance of MD=36.46m (95% CI, 15.14-57.79; P<.001) and MD=12.51m (95% CI, 4.79-20.23; P=.001), respectively. No improvement was found for TUG (MD=-1.05s; 95% CI, -2.19 to .09; P=.07).
  
  
  CONCLUSIONS
  Our meta-analysis suggests that exercise improves walking speed and endurance in pwMS.
authors.affiliation: University of New England, School of Science and Technology, Armidale, New South Wales, Australia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Pearson
authors.affiliation: University of New England, School of Science and Technology, Armidale, New South Wales, Australia.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Dieberg
authors.affiliation: University of New England, School of Science and Technology, Armidale, New South Wales, Australia. Electronic address: nsmart2@une.edu.au.
authors.forename: Neil
authors.initials: N
authors.lastname: Smart
mesh_terms: D015444:Exercise / Q000502:physiology; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D009043:Motor Activity; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D016138:Walking / Q000502:physiology*
keywords: Exercise therapy; Meta-analysis; Multiple sclerosis; Rehabilitation; Walking