Physical activity guidelines’ impact on cognition in multiple sclerosis: a systematic review and meta-analysis of randomized clinical trials

Purpose This systematic review and meta-analysis aimed to determine the effects of meeting physical activity guidelines for people with multiple sclerosis (PAG-MS) on cognition in people with multiple sclerosis (MS). Meeting PAG-MS has shown to elicit numerous health benefits in people with MS; minimal work has examined the influence of PAG-MS on cognition.Materials and methods A systematic search was conducted in PubMed, EMBASE, Web of Science, SPORTDiscuss, Scopus, and PsycINFO. Two independent reviewers assessed included studies for eligibility, extracted data, and evaluated risk of bias. Randomized controlled trials (RCTs) including physical activity that met PAG-MS and assessed cognition were included.Results Twelve randomized controlled trials met the inclusion criteria with 462 total participants. Eleven studies showed improvement in at least one aspect of cognition. Meta-analyses indicated meeting PAG-MS significantly improved processing speed (SMD = 0.29; 95% CI 0.08–0.51; p = 0.008), visuospatial memory (SMD = 0.47; 95% CI 0.14–0.80; p = 0.005), and verbal memory (SMD = 0.75; 95% CI 0.27–1.23; p = 0.002).Conclusion Meta-analyses indicated meeting PAG-MS significantly improved processing speed and memory. The findings were based on a limited number of studies with a high risk of bias and more RCTs that meet PAG-MS and examine cognition are needed.