Effects of exercise on balance function in people with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE

This systematic review and meta-analysis aimed to evaluate the effect of exercise on balance function in multiple sclerosis (MS) patients and identify the optimal exercise prescription for this population.

METHODS

A comprehensive search was conducted across PubMed, Web of Science, EBSCO, Cochrane, and Scopus up to February 21, 2025. The data were pooled using weighted mean differences (WMD) and 95% confidence interval.

RESULTS

Fifty-two studies fulfilled the inclusion criteria. Exercise significantly improved Berg balance scale (BBS; WMD, 4.03; p < 0.00001) and timed up and go test (TUG; WMD, -1.01; p < 0.00001) in MS patients. The subgroup analyses revealed that resistance exercise (WMD, 6.07; p = 0.004), interventions lasting ≥ 8 weeks (WMD, 4.24; p < 0.00001), ≥ 3 times per week (WMD, 4.57; p < 0.00001), ≥ 60 min per session (WMD, 4.36; p < 0.00001), ≥ 180 min per week (WMD, 4.41; p < 0.00001) were most effective in improving BBS. Greater improvements were observed in patients aged < 45 years (WMD, 4.57; p < 0.00001) and those with baseline EDSS > 3.5 (WMD, 3.97; p < 0.00001).

CONCLUSIONS

Exercise was found to improve balance in MS patients. Our results suggest that MS patients may benefit from engaging in exercise sessions at least three times per week, with each session lasting 60 min or more, for a minimum duration of 8 weeks. Achieving a weekly exercise goal of 180 min or more may further enhance balance function.