Impact of aerobic exercise on clinical and magnetic resonance imaging biomarkers in persons with multiple sclerosis: An exploratory randomized controlled trial.
Lina Savšek, Tamara Stergar, Vojko Strojnik and 4 others
PMID 33739437WHAT IT FOUND
Aerobic exercise did not stop whole-brain shrinkage in MS patients on fingolimod.
It may have preserved some specific brain structures and slightly improved walking speed, but did not help thinking or quality of life. Some participants felt social pressure during group sessions.
Key findings
01The intervention did not reduce whole-brain or grey matter atrophy, which was the primary focus.
02Walking speed showed a slight improvement, but disability scores and cognitive outcomes did not change significantly.
03Participants reported negative effects on social functioning and energy levels, linked to peer pressure and scheduling burdens.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was very small (28 participants), increasing the risk of missing true effects. The study duration was only 12 weeks, which is too short to detect significant changes in brain volume or long-term disease progression. Participants were already on fingolimod, so the results may not apply to those on other medications or no medication. The control group continued their normal routine, so there was no active comparison intervention to control for social interaction or attention effects. Some participants dropped out or had missing data, and the analysis did not account for these losses with imputation.
Declared interests
No conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the preservation of specific brain structures as evidence that aerobic exercise stops MS progression. The primary outcome of whole-brain atrophy was null, and the study was too small and short to confirm any neuroprotective benefit. The negative impact on social functioning and energy levels is a real finding that should not be overlooked.