Systematic Review on Exercise Training as a Neuroplasticity-Inducing Behavior in Multiple Sclerosis.

Only 10 papers met the criteria, and their samples ranged from 2 to 35 persons with MS, so the review cannot settle whether exercise changes the brain. Most included studies were pilot or feasibility trials in mild relapsing-remitting MS, which limits how broadly the findings apply. Nine of the 10 studies had risk of bias from lack of statistical power and lack of masked participants or personnel. Allocation concealment and selective reporting were largely not reported in a majority of papers. The exercise programs varied in modality, duration, frequency, setting, and supervision, and the brain and function outcomes varied too, so results are hard to compare. People with progressive MS or severe ambulatory disability were not represented, so the findings do not speak to those patients.

The authors declared no potential conflicts of interest. The text does not state who funded the review.

Do not read this review as proof that exercise training causes neuroplasticity in MS. Functional improvements were common, but brain changes were inconsistent and often not linked to function, and the included studies were mostly small, underpowered, and at high risk of bias.