Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis

Background: There has been an exponential growth in the number of clinical research studies regarding exercise training in multiple sclerosis, and literature reviews and meta-analyses have documented the many benefits of exercise training. This research further requires careful review for documenti...

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Main Authors: Learmonth, Y.C., Pilutti, L.A., Herring, M.P., Motl, R.W., Chan, Bryan, Metse, A.P.
Format: Journal Article
Published: 2021
Online Access:http://hdl.handle.net/20.500.11937/86205
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author Learmonth, Y.C.
Pilutti, L.A.
Herring, M.P.
Motl, R.W.
Chan, Bryan
Metse, A.P.
author_facet Learmonth, Y.C.
Pilutti, L.A.
Herring, M.P.
Motl, R.W.
Chan, Bryan
Metse, A.P.
author_sort Learmonth, Y.C.
building Curtin Institutional Repository
collection Online Access
description Background: There has been an exponential growth in the number of clinical research studies regarding exercise training in multiple sclerosis, and literature reviews and meta-analyses have documented the many benefits of exercise training. This research further requires careful review for documenting the safety of exercise training in multiple sclerosis, as clarity on safety represents a major hurdle in the clinical prescription of exercise behaviour. Objectives: To enhance understanding of the feasibility of exercise in multiple sclerosis, we (1) provide a protocol of a systematic review and meta-analysis that summarises rates and risks of clinical relapse, adverse events (i.e., an unfavourable outcome that occurs during the intervention delivery time period), and serious adverse events (i.e., an untoward occurrence that results in death or is life threatening, requires hospitalisation, or results in disability during the intervention delivery time period), as well as retention, adherence, and compliance, from randomised controlled trials of exercise training in persons with multiple sclerosis; and (2) identify moderators of relapse, adverse events, and serious adverse event rates. Methods: Eight field-relevant databases will be searched electronically. Studies that involve a randomised controlled trial of exercise training (with non-exercise, non-pharmacological, comparator), report on safety outcomes, and include adults with multiple sclerosis will be included. Rates and relative risks of the three primary outcomes (relapse, adverse event, and serious adverse event) will be calculated and reported each with standard error and 95% confidence interval. Random-effects meta-analysis will estimate mean population relative risk for outcomes. Potential sources of variability, including participant characteristics, features of the exercise stimulus, and comparison condition, will be examined with random-effects meta-regression with maximum likelihood estimation. Discussion: The results from this systematic review and meta-analysis will inform and guide healthcare practitioners, researchers, and policymakers on the safety of exercise training in persons with multiple sclerosis. Where possible, we will identify the impact of exercise type, exercise delivery style, participant disability level, and the prescription of exercise guidelines, on the safety of exercise training. The result will identify critical information on the safety of exercise in persons with multiple sclerosis, while also identifying gaps in research and setting priorities for future enquiries.
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spelling curtin-20.500.11937-862052021-11-04T01:21:45Z Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis Learmonth, Y.C. Pilutti, L.A. Herring, M.P. Motl, R.W. Chan, Bryan Metse, A.P. Background: There has been an exponential growth in the number of clinical research studies regarding exercise training in multiple sclerosis, and literature reviews and meta-analyses have documented the many benefits of exercise training. This research further requires careful review for documenting the safety of exercise training in multiple sclerosis, as clarity on safety represents a major hurdle in the clinical prescription of exercise behaviour. Objectives: To enhance understanding of the feasibility of exercise in multiple sclerosis, we (1) provide a protocol of a systematic review and meta-analysis that summarises rates and risks of clinical relapse, adverse events (i.e., an unfavourable outcome that occurs during the intervention delivery time period), and serious adverse events (i.e., an untoward occurrence that results in death or is life threatening, requires hospitalisation, or results in disability during the intervention delivery time period), as well as retention, adherence, and compliance, from randomised controlled trials of exercise training in persons with multiple sclerosis; and (2) identify moderators of relapse, adverse events, and serious adverse event rates. Methods: Eight field-relevant databases will be searched electronically. Studies that involve a randomised controlled trial of exercise training (with non-exercise, non-pharmacological, comparator), report on safety outcomes, and include adults with multiple sclerosis will be included. Rates and relative risks of the three primary outcomes (relapse, adverse event, and serious adverse event) will be calculated and reported each with standard error and 95% confidence interval. Random-effects meta-analysis will estimate mean population relative risk for outcomes. Potential sources of variability, including participant characteristics, features of the exercise stimulus, and comparison condition, will be examined with random-effects meta-regression with maximum likelihood estimation. Discussion: The results from this systematic review and meta-analysis will inform and guide healthcare practitioners, researchers, and policymakers on the safety of exercise training in persons with multiple sclerosis. Where possible, we will identify the impact of exercise type, exercise delivery style, participant disability level, and the prescription of exercise guidelines, on the safety of exercise training. The result will identify critical information on the safety of exercise in persons with multiple sclerosis, while also identifying gaps in research and setting priorities for future enquiries. 2021 Journal Article http://hdl.handle.net/20.500.11937/86205 10.1186/s13643-021-01751-0 http://creativecommons.org/licenses/by/4.0/ fulltext
spellingShingle Learmonth, Y.C.
Pilutti, L.A.
Herring, M.P.
Motl, R.W.
Chan, Bryan
Metse, A.P.
Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis
title Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis
title_full Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis
title_fullStr Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis
title_full_unstemmed Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis
title_short Safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis
title_sort safety of exercise training in multiple sclerosis: a protocol for an updated systematic review and meta-analysis
url http://hdl.handle.net/20.500.11937/86205