Changes in walking speed following resistance training in people with multiple sclerosis: A systematic review and meta-analysis.

Almost everyone studied had relapsing-remitting MS and mild to moderate disability, with walking speeds well above the level at which walking becomes a struggle, so there is little here for people with progressive MS or more severe walking limitation. The authors note this themselves. The trials were small and their results varied a lot. The confidence interval around the pooled estimate ran from 0.01 to 0.19 m/s, so the lower end is very close to no effect at all. Six of the twelve trials reported no between-group results, and several scored only 3 to 5 out of 10 on the PEDro quality scale, mostly because the person deciding who got which treatment could see the allocation and because nobody could be blinded to exercise. Dose was never compared directly, so the review cannot say how much training, how often, or how hard is best. The review looked only at walking speed, not at overall walking ability, self-reported walking, or whether a faster walk changes what someone does day to day.

The research received no specific grant from any public, commercial or not-for-profit funding agency, and all authors report no conflicts of interest.

Do not read the 0.10 m/s pooled result as proof that resistance training is the answer for your patient. The confidence interval ran from 0.01 to 0.19 m/s, only one of the six trials that compared training with usual activity found a difference between the groups, and no trial found resistance training better than another form of exercise.