Evidence mapPaperPMID 40167216Full record

SynthesisPhysical therapy2025

Meeting Physical Activity Guidelines for Persons With Multiple Sclerosis Reduces Fatigue Severity and Impact: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Libak Abou, Tanner Murphy, Ethan Truong, Joseph Peters

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Physical therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Libak AbouDepartment of Physical Medicine & Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, United States.ORCID 0000-0001-6404-7623
Tanner MurphyKansas City University College of Osteopathic Medicine, Kansas City University of Medicine and Bioscience, Kansas City University, Kansas City, MO 64106, United States.
Ethan TruongCollege of Liberal Arts & Sciences, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States.
Joseph PetersKansas City University College of Osteopathic Medicine, Kansas City University of Medicine and Bioscience, Kansas City University, Kansas City, MO 64106, United States.

Funding

CTSA K12 Program at the University of MichiganK12TR004374 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI VICKI L ELLINGROD, Leah Elizabeth Robinson · 2023 to 2026
$6.5M
Michigan Institute for Clinical and Health Research-MICHR K12 program K12TR004374NCATS NIH HHS K12 TR004374
6 · The paper itself

Abstract

objectiveRegular physical activity is a recommended behavioral goal for persons with multiple sclerosis. This review aimed to determine the effect of interventions that met physical activity guidelines for persons with multiple sclerosis on fatigue measures and to compare the magnitudes of the effect sizes for meeting these guidelines with the minimal clinically important differences for fatigue measures.

methodsThe search was conducted in PubMed, Embase, Web of Science, SPORTDiscus, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and PsycINFO from inception to October 2024. Only randomized clinical trials that explicitly met physical activity guidelines and evaluated fatigue were included. Two independent reviewers screened articles for inclusion and evaluated the risk of bias of included trials using the Cochrane risk-of-bias tool for randomized trials. Findings were summarized, and a meta-analysis was conducted. Fatigue measures included the Fatigue Severity Scale, Fatigue Impact Scale, and modified Fatigue Impact Scale. The Grading of Recommendations, Assessment, Development and Evaluation was used to evaluate the quality of the evidence. The review protocol was preregistered in the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number: CRD42023387305).

resultsTwenty-two randomized clinical trials with 920 participants were included in the review; 17 studies were included in the meta-analysis. Findings indicated that interventions meeting physical activity guidelines for at least 4 weeks significantly reduced fatigue severity (standardized mean difference = -1.46; 95% CI = -2.11 to -0.81) and fatigue impact measured with the modified Fatigue Impact Scale (mean difference = -11.88; 95% CI = -20.57 to -3.19) and Fatigue Impact Scale (mean difference = -21.08; 95% CI = -31.01 to -11.15). All findings were clinically relevant, with effect sizes exceeding the established minimal clinically important differences for the fatigue measures. Some methodological concerns were noted, and the evidence level ranged from very low to moderate.

conclusionsEvidence suggests that engaging in physical activity for at least 150 minutes per week or 2 sessions of 10 to 30 minutes of moderate-intensity aerobic training plus 2 sessions of resistance training per week results in clinically significant reductions in fatigue severity and impact necessary to improve the quality of life of persons with multiple sclerosis. IMPACT: Fatigue is a highly prevalent symptom associated with poor outcomes, including falls, activity restrictions, pain, cognitive problems, functional limitations, and mortality risk among persons with multiple sclerosis. Our study suggests that adhering to physical activity guidelines developed for persons with multiple sclerosis clinically reduces the severity and impact of fatigue. This regimen includes engaging in physical activity for at least 150 minutes per week or participating in 2 sessions of 10 to 30 minutes of moderate-intensity aerobic training plus 2 sessions of resistance training per week.

Indexed as

ExerciseExercise TherapyFatigueMultiple SclerosisHumansRandomized Controlled Trials as TopicSeverity of Illness IndexExerciseFatigueMultiple SclerosisPhysical ActivityRehabilitation

Identifiers

PMID40167216
PMCPMC12166980

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.