Prescribing Resistance Training in Multiple Sclerosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abstract

Resistance training is a promising therapy for individuals with multiple sclerosis, yet evidence-based guidance on the optimal dosage and specific clinical protocols remains insufficient. To evaluate the effects of resistance training on muscle strength, walking performance, fatigue, and quality of life in people with multiple sclerosis, and to synthesize these findings into a practical frequency, intensity, time, and type framework. Eighteen randomized controlled trials were included. Compared to usual care, resistance training significantly improved knee extensor strength, walking speed, endurance, functional mobility, fatigue, and quality of life. Subgroup analysis revealed a dose-response relationship: data for ≤20 sessions were insufficient to confirm functional benefits, while programs exceeding 20 sessions consistently demonstrated significant gains in functional walking, mobility, and quality of life. Resistance training was generally safe with only minor adverse events reported. Resistance training is effective and safe for ambulatory individuals with multiple sclerosis. While strength gains occur early, evidence suggests that programs exceeding 20 sessions may be more consistently associated with meaningful improvements in functional walking and quality of life.