Physiotherapy · 2026
Effects of physical exercise on spasticity in people with multiple sclerosis: A systematic review.
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González-Mingorance Lydia, Andreu-Caravaca Luis, Rubio-Arias Jacobo Á
Аннотация
BACKGROUND: Spasticity is one of the most prevalent symptoms that affect the quality of life of people with multiple sclerosis (MS). Physical exercise has been proposed as a non-pharmacological intervention that may positively influence spasticity; however, the effects remain unclear.
OBJECTIVE: To analyse the effectiveness of different physical exercise interventions on spasticity in people with MS.
DATA SOURCES: A systematic search was conducted in four databases.
STUDY SELECTION: Studies were included if they were randomised controlled trials that enrolled people with MS with an Expanded Disability Status Scale (EDSS) score ≤6.0 and assessed spasticity. Studies in which participants with MS had other conditions and the results were not reported separately for the MS subgroup were excluded.
SYNTHESIS METHODS: Results were synthesised narratively. Participant characteristics, exercise training variables, and spasticity outcomes were extracted and summarised across included studies.
RESULTS: Thirteen randomised controlled trials were included: resistance (n = 1), flexibility (n = 4), neuromotor/stability (n = 1), aerobic cycle ergometry (n = 2), alternative modalities (yoga/climbing; n = 1), and multicomponent programmes (n = 4). Overall, these interventions were associated with reductions in spasticity. However, intervention protocols varied substantially, and several spasticity measures may lack adequate sensitivity to detect clinically meaningful change.
CONCLUSION: Physical exercise appears to reduce spasticity in ambulatory MS patients (EDSS score <6), with the most consistent improvements reported in programmes incorporating flexibility/range-of-motion work; however, heterogeneity in intervention protocols, incomplete reporting of training dose, and limitations of commonly used spasticity measures reduce confidence in the magnitude of the effects, and highlight the need for well-designed trials using more valid outcomes.
OBJECTIVE: To analyse the effectiveness of different physical exercise interventions on spasticity in people with MS.
DATA SOURCES: A systematic search was conducted in four databases.
STUDY SELECTION: Studies were included if they were randomised controlled trials that enrolled people with MS with an Expanded Disability Status Scale (EDSS) score ≤6.0 and assessed spasticity. Studies in which participants with MS had other conditions and the results were not reported separately for the MS subgroup were excluded.
SYNTHESIS METHODS: Results were synthesised narratively. Participant characteristics, exercise training variables, and spasticity outcomes were extracted and summarised across included studies.
RESULTS: Thirteen randomised controlled trials were included: resistance (n = 1), flexibility (n = 4), neuromotor/stability (n = 1), aerobic cycle ergometry (n = 2), alternative modalities (yoga/climbing; n = 1), and multicomponent programmes (n = 4). Overall, these interventions were associated with reductions in spasticity. However, intervention protocols varied substantially, and several spasticity measures may lack adequate sensitivity to detect clinically meaningful change.
CONCLUSION: Physical exercise appears to reduce spasticity in ambulatory MS patients (EDSS score <6), with the most consistent improvements reported in programmes incorporating flexibility/range-of-motion work; however, heterogeneity in intervention protocols, incomplete reporting of training dose, and limitations of commonly used spasticity measures reduce confidence in the magnitude of the effects, and highlight the need for well-designed trials using more valid outcomes.