Therapeutic exercises and its impact on fatigue, physical endurance and exercise tolerance in late-onset muscular dystrophies: a systematic review & meta-analysis.

BACKGROUND

Muscular dystrophy (MD) is a progressive neuromuscular disorder characterized by muscle degeneration, leading to fatigue, reduced endurance, and impaired functional capacity. Evidence regarding the role of therapeutic exercises in late-onset muscular dystrophies (LOMD) remains limited and inconclusive.

METHODS

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted in accordance with PRISMA guidelines. Electronic databases including MEDLINE, Scopus, and Web of Science were searched from inception to September 2025. Eligible studies evaluated the effects of therapeutic exercises on fatigue, exercise tolerance, and aerobic capacity in individuals with LOMD. Data extraction and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted using a random-effects model.

RESULTS

Eight RCTs involving 501 participants were included. Meta-analysis demonstrated small, statistically non-significant effects of therapeutic exercises on fatigue (SMD = -0.20; 95% CI: -0.72 to 0.33; p = 0.46), exercise tolerance (SMD = 0.16, 95% CI: -0.06 to 0.38; p = 0.15), and aerobic power (SMD = 0.12; 95% CI: -0.24 to 0.48; p = 0.51). Heterogeneity ranged from low to high across outcomes.

CONCLUSION

Therapeutic exercises appears to be a safe adjunct intervention and may provide small, although statistically non-significant, improvements in fatigue, exercise tolerance, and aerobic capacity in individuals with LOMD. While the findings suggest potential clinical benefits, the limited number of high-quality trials and heterogeneity warrant cautious interpretation. Further large-scale, well-designed RCTs are required to establish definitive evidence.