运动干预对多发性硬化患者疲劳症状影响的Meta分析

doi:10.3969/j.issn.1006-9771.2022.05.012

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (5): 568-577.doi: 10.3969/j.issn.1006-9771.2022.05.012

运动干预对多发性硬化患者疲劳症状影响的Meta分析

徐振¹,王一迪²,张月³,温宇红^4,⁵()

1.南开大学体育部,天津市 300071
2.北京体育大学中国游泳运动学院,北京市 100084
3.上海交通大学体育系,上海市 200240
4.北京体育大学体育休闲与旅游学院,北京市 100084
5.北京体育大学运动与体质健康教育部重点实验室,北京市 100084

收稿日期:2021-12-09 修回日期:2022-02-07 出版日期:2022-05-25 发布日期:2022-06-10
通讯作者: 温宇红 E-mail:wyhswim@126.com
作者简介:徐振(1997-),男,汉族,黑龙江哈尔滨市人,硕士,助教,主要研究方向：运动与健康促进
基金资助:
国家重点研发计划项目(2020YFC2006700)

Effects of exercise intervention on fatigue for patients with multiple sclerosis: a meta-analysis

XU Zhen¹,WANG Yidi²,ZHANG Yue³,WEN Yuhong^4,⁵()

1. Department of Physical Education, Nankai University, Tianjin 300071, China
2. China Swimming College, Beijing Sport University, Beijing 100084, China
3. Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China
4. School of Recreational Sports and Tourism, Beijing Sport University, Beijing 100084, China
5. Key Laboratory of Sports and Physical Health of the Ministry of Education, Beijing Sport University, Beijing 100084, China

Received:2021-12-09 Revised:2022-02-07 Published:2022-05-25 Online:2022-06-10
Contact: WEN Yuhong E-mail:wyhswim@126.com
Supported by:
National Key Research and Development Program(2020YFC2006700)

摘要/Abstract

摘要：

目的评价运动干预对多发性硬化(MS)患者疲劳症状的影响及其安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trails、Web of Science、中国知网和万方数据库,收集从建库至2021年6月发表的关于运动干预对MS疲劳影响的随机对照试验。由两名研究人员进行文献检索与筛选,并独立对纳入文献进行质量评价。采用Stata 16.0软件进行Meta分析。结果共纳入41项随机对照试验,共2 155例患者。与对照组相比,运动干预能显著改善试验组疲劳症状(SMD = -0.59, 95%CI -0.73~-0.44, P < 0.001);随访期间试验组与对照组无显著性差异(SMD = -0.07,95%CI -0.26~0.12, P = 0.47)。运动干预未增加复发风险(RR = 0.67, 95%CI 0.45~1.00, P = 0.06)。结论运动干预能够有效减轻MS疲劳症状,且未造成MS复发率的升高。

关键词: 多发性硬化, 运动, 疲劳, Meta分析

Abstract:

Objective To evaluate the effect and safety of exercise intervention on fatigue for patients with multiple sclerosis (MS). Methods Randomized controlled trials (RCT) about effect of exercise intervention on MS fatigue were retrieved from the databases of PubMed, Cochrane Central Register of Controlled Trails, Web of Science, CNKI and Wanfang Data from establishment to June, 2021. Two researchers independently screened the literature, extracted the data and assessed the quality of eligible studies. Meta-analysis was performed with Stata 16.0. Results A total of 41 RCT with 2 155 patients were included. Compared with control group, exercise intervention might improve the MS fatigue at the end of intervention in exercise group (SMD = -0.59, 95%CI -0.73 to -0.44, P < 0.001). There was no significant difference between the exercise group and the control group in follow-up period (SMD = -0.07, 95%CI -0.26 to 0.12, P = 0.47). Exercise intervention did not increase the recurrence of MS (RR = 0.67, 95%CI 0.45 to 1.00, P = 0.06). Conclusion Exercise intervention can effectively relieve the fatigue of MS without increasing the recurrence of MS.

Key words: multiple sclerosis, exercise, fatigue, meta-analysis

中图分类号:

R744.5

徐振,王一迪,张月,温宇红. 运动干预对多发性硬化患者疲劳症状影响的Meta分析[J]. 《中国康复理论与实践》, 2022, 28(5): 568-577.

XU Zhen,WANG Yidi,ZHANG Yue,WEN Yuhong. Effects of exercise intervention on fatigue for patients with multiple sclerosis: a meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(5): 568-577.

图/表 4

图1

表1

纳入研究的基本特征"

纳入研究	受试者特征				干预方案	持续时间/周	随访时间	结局指标	PEDro分	检验效能
纳入研究	n	性别(男/女)/n	年龄/岁	MS分型(EDSS)	干预方案	持续时间/周	随访时间	结局指标	PEDro分	检验效能
Ahmadi等^[32] (2013)	E1:10 E2:11 C:10	E1:0/10 E2:0/11 C:0/10	E1:36.8±9.2 E2:32.3±8.7 C:36.7±9.3	NR (1~4)	E1:有氧运动,30 min E2:其他(瑜伽),60~70 min 每周3次	8	NR	FSS	6	99%
Bahmani等^[33] (2019)	E1:26 E2:24 C:21	E1:0/26 E2:0/24 C:0/21	E1:37.9±8.7 E2:39.2±8.7 C:37.9±9.9	NR (< 6)	E1:有氧运动 E2:其他(协调) 30~45 min,每周3次	8	NR	FSS	8	55%
Brichetto等^[55] (2013)	E:18 C:18	E1:8/10 C:6/12	E1:40.7±11.5 C:43.2±10.6	NR (≤ 6)	其他(视频游戏) 60 min,每周3次	12	NR	MFIS	7	83%
Briken等^[24] (2014)	E1:10 E2:11 E3:11 C:10	E1:5/5 E2:4/7 E3:5/6 C:4/6	E1:49.1±8.5 E2:50.9±9.2 E3:48.8±6.8 C:50.4±7.6	SP/PP (4~6)	不同形式的有氧运动(上肢;划船;骑行) 15~45 min,每周2~3次	8~10	NR	MFIS	6	14%
Burschka等^[56] (2014)	E:15 C:17	E:5/10 C:5/12	E:42.6±9.4 C:43.6±8.0	RR/SP (< 5)	其他(太极) 90 min,每周1次	24	NR	FSMC	4	96%
Cakt等^[38] (2010)	E1:14 E2:10 C:9	E1:5/9 E2:2/8 C:3/6	E1: 36.4±10.5 E2: 43.0±10.2 C: 35.5±10.9	RR/SP (≤ 6)	不同形式的抗阻运动(功率自行车;居家徒手训练),30 min,每周2次	8	NR	FSS	6	6%
Callesen等^[35] (2020)	E1:23 E2:28 C:20	E1:7/16 E2:5/23 C:4/16	51~56	RR/SP/ PP (2~6.5)	E1:抗阻运动 E2:任务导向训练 60 min,每周2次	10	NR	MFIS	8	94%
Carter等^[39] (2014)	E:60 C:60	E:17/43 C:17/43	E:45.7±9.1 C:46.0±8.4	RR/SP/ PP (1~6.5)	混合运动 60 min,每周3次	12	6月	MFIS	8	63%
Castro-Sanchez等^[57](2012)	E:36 C:37	E:10/26 C:13/24	E:46.0±9.9 C:50±12.3	SP/PP (≤ 7.5)	其他(水中运动) 60 min,每周2次	20	10周	FSS	8	26%
Dalgas等^[36] (2010)	E:15 C:16	E:5/10 C:6/10	E:47.7±10.4 C:49.1±8.4	RR (3~5.5)	抗阻运动,每周2次	12	12周	FSS	6	13%
Dodd等^[37] (2011)	E:36 C:35	E:10/26 C:9/26	E:47.7±10.8 C:50.4±9.6	RR (NR)	抗阻运动 45 min,每周2次	10	12周	MFIS	8	34%
Eftekhari等^[58] (2018)	E:13 C:12	E:0/13 C:0/12	E:34.5±7.3 C:31.4±8.9	RR (2~6)	其他(普拉提) 50~60 min,每周3次	8	NR	MFIS	5	73%
Escudero-Uribe等^[40](2017)	E:30 C:18	E:11/19 C:4/14	E:43.1±10.2 C:43.0±9.3	RR (≤ 4.5)	混合运动 60~100 min,每周2次	12	NR	FSS	6	69%
Feys等^[52] (2017)	E:21 C:21	E:1/20 C:3/18	E:36.6±8.5 C:44.4±8.5	NR (NR)	任务导向训练(跑步5 km) 每周3次	12	NR	FSMC	5	19%
Garrett等^[49] (2013)	E1:63 E2:67 E3:63 C:49	E1:13/50 E2:22/45 E3:19/44 C:6/43	E1:51.7±10 E2:50.3±10 E3:49.6±10 C:48.8±11	RR/SP/ PP (NR)	E1/E2：混合运动 E3:其他(瑜伽) 60 min,每周3次	10	NR	MFIS	8	12%
Geddes等^[53] (2009)	E:8 C:4	E:2/6 C:1/3	E:40~64 C:22~50	RR/PP (≤ 6)	任务导向训练 20~30 min,每周3次	12	NR	FSS	5	5%
Heine等^[25] (2017)	E:43 C:46	E:11/32 C:13/33	E:43.1±9.8 C:48.2±9.2	RR/SP/ PP(≤ 6)	有氧运动 30 min,每周3次	16	10周	FSS	8	7%
Hebert等^[31] (2011)	E1:12 E2:13 C:13	E1:3/9 E2:2/11 C:2/11	E1: 46.8±10 E2: 42.6±10 C: 50.2±9.2	RR/SP (NR)	E1:其他(前庭),55 min E2:有氧运动,30 min 每周2次	6	4周	MFIS	8	51%
Hogan等^[34] (2014)	E1:48 E2:35 E3:13 C:15	E1:18/30 E2:15/20 E3:5/8 C:2/13	E1:57±10 E2:52±11 E3:58±8 C:49±6	RR/SP/ PP (NR)	E1/E2:抗阻运动, E3:其他(瑜伽) 60 min,每周1次	10	NR	MFIS	7	27%
Kalron等^[59] (2017)	E:22 C:23	E:8/14 C:8/15	E:42.9±7.2 C:44.4±6.6	RR (3~6)	其他(普拉提) 30 min,每周1次	12	NR	MFIS	7	6%
Kooshiar等^[60] (2015)	E:18 C:19	E:0/18 C:0/19	29.2±7.9	RR/SP (1~5.5)	其他(水中运动) 45 min,每周3次	8	NR	MFIS	5	51%
Learmonth等^[41] (2012)	E:20 C:12	E:5/15 C:4/8	E:51.4±8.0 C:51.8±8.0	NR (5~6.5)	混合运动 45~60 min,每周2次	12	NR	FSS	7	73%
Learmonth等^[42] (2017)	E:29 C:28	E:1/28 C:1/27	E:48.7±10.4 C:48.2±9.1	RR/SP (NR)	混合运动,每周2次	16	NR	FSS	6	52%
Mostert等^[27](2002)	E:13 C:13	E:3/10 C:2/11	E:45.2±8.6 C:43.9±13.9	RR/SP/ PR (1~6.5)	有氧运动 30 min,每周5次	4	NR	FSS	5	12%
Negahban等^[43] (2013)	E1:12 E2:12 C:12	E1:2/10 E2:2/10 C:2/10	E1:36.7±6.7 E2:36.7±7.6 C:36.8±8.7	RR/SP (2~6)	E1/E2:混合运动 30 min,每周3次	5	NR	FSS	7	49%
Oken等^[30] (2004)	E1:15 E2:22 C:20	E1:2/13 E2:2/20 C:0/20	E1:48.8±10.4 E2:49.8±7.4 C:48.4±9.8	NR (≤ 6)	E1:其他(瑜伽),90 min E2:有氧运动,60 min 每周1次	24	NR	POMS	6	79%
Ozdogar等^[50] (2020)	E1:21 E2:19 C:20	E1:5/16 E2:6/13 C:5/15	E1:39.2±8.6 E2:43.6±10.5 C:37.9±12.4	RR/SP (≤ 5)	E1:其他(视频游戏) E2:混合运动 45 min,每周1次	8	NR	MFIS	6	35%
Ozkul等^[44] (2018)	E:18 C:18	E:4/14 C:4/14	E:34.5±12.8 C:34.0±8.7	RR (< 5)	混合运动 90 min,每周3次	8	NR	FSS	6	99%
Ozkul等^[45] (2020)	E1:13 E2:13 C:13	E1:4/9 E2:2/11 C:3/10	E1:29.0±11.8 E2:34.0±14.8 C:34.0±7.8	RR (< 6)	混合运动 40~50 min,每周2次	8	NR	FSS	7	97%
Petajan等^[29] (1996)	E:21 C:25	E:6/15 C:9/16	E:41.1±9.2 C:39.0±8.5	NR (≤ 6)	有氧运动 50 min,每周3次	15	NR	POMS	5	6%
Razazian等^[61] (2016)	E1:18 E2:18 C:18	E1:0/18 E2:0/18 C:0/18	E1:33.3±7.4 E2:35.4±6.9 C:33.1±6.6	RR/SP/ PR (≤ 6)	E1:其他(瑜伽) E2:其他(水中运动) 60 min,每周3次	8	NR	FSS	8	100%
Sangelaji等^[46] (2014)	E:39 C:22	E:15/24 C:7/15	E:33.0±7.7 C:32.0±6.3	RR (≤ 4)	混合运动 90 min,每周3次	10	NR	FSS	4	11%
Schulz等^[28] (2004)	E:15 C:13	E:4/11 C:5/8	E:39±9 C:40±11	RR/SP/ PP(< 5)	有氧运动 30 min,每周2次	8	NR	MFIS	5	38%
Skjerbaek等^[26] (2014)	E:6 C:5	3/8	E:62.0±5.9 C:55.2±8.2	SP/PP (6.5~8)	有氧运动 3×6 min,每周2~3次	4	NR	FSMC	7	5%
Straudi等^[54] (2014)	E:12 C:12	E:5/7 C:2/10	E:49.9±7.5 C:55.2±13.8	RR/SP/ PP (4~5.5)	任务导向训练 120 min(含休息),每周5次	2	12周	FSS	7	56%
Sutherland等^[23] (2001)	E:11 C:11	E:5/6 C:5/6	E:47.2±4.7 C:45.4±5.0	NR (≤ 5)	有氧运动 45 min,每周3次	10	NR	POMS	6	9%
Tarakci等^[47] (2013)	E:51 C:48	E:17/34 C:18/30	E:41.5±9.4 C:39.6±11.2	RR/SP/ PP (2~6.5)	混合运动 60 min,每周3次	12	NR	FSS	7	100%
van den Berg等^[22] (2006)	E:8 C:8	E:1/7 C:1/7	30~65	NR (NR)	有氧运动 30 min,每周3次	4	5周	FSS	6	5%
Yazgan等^[62] (2020)	E1:15 E2:12 C:15	E1:2/13 E2:0/12 C:2/13	E1:47.5±10.5 E2:43.1±8.7 C:40.7±8.8	RR/SP/ PP/PR (2.5~6)	E1/E2:其他(视频游戏) 60 min,每周2次	8	NR	FSS	6	15%
Young等^[51] (2019)	E1:27 E2:26 C-28	E1:5/22 E2:6/20 C:4/24	E1:49.7±9.4 E2:48.4±9.9 C:47.3±10.3	NR (≤ 6)	E1:混合运动 E2:其他(瑜伽) 60 min,每周3次	12	NR	PRO MIS	8	27%
朱琳等^[48](2011)	E:19 C:10	E:8/11 C:4/6	E:42.9±16.9 C:44.7±10.9	NR (NR)	混合运动 30 min,每周3次	4	NR	FSS	5	31%

表1

表2

图2

参考文献 72

[1]	THOMPSON A J, BARANZINI S E, GEURTS J, et al. Multiple sclerosis[J]. Lancet, 2018, 391(10130): 1622-1636. doi: 10.1016/S0140-6736(18)30481-1
[2]	PILUTTI L A, GREENLEE T A, MOTL R W, et al. Effects of exercise training on fatigue in multiple sclerosis: a meta-analysis[J]. Psychosom Med, 2013, 75(6): 575-580. doi: 10.1097/PSY.0b013e31829b4525
[3]	MANJALY Z M, HARRISON N A, CRITCHLEY H D, et al. Pathophysiological and cognitive mechanisms of fatigue in multiple sclerosis[J]. J Neurol Neurosurg Psychiatry, 2019, 90(6): 642-651. doi: 10.1136/jnnp-2018-320050
[4]	KLUGER B M, KRUPP L B, ENOKA R M. Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy[J]. Neurology, 2013, 80(4): 409-416. doi: 10.1212/WNL.0b013e31827f07be
[5]	LAROCCA N G. Impact of walking impairment in multiple sclerosis: perspectives of patients and care partners[J]. Patient, 2011, 4(3): 189-201. doi: 10.2165/11591150-000000000-00000
[6]	MOTL R W, SANDROFF B M, KWAKKEL G, et al. Exercise in patients with multiple sclerosis[J]. Lancet Neurol, 2017, 16(10): 848-856. doi: 10.1016/S1474-4422(17)30281-8
[7]	PEDERSEN B K, SALTIN B. Exercise as medicine-evidence for prescribing exercise as therapy in 26 different chronic diseases[J]. Scand J Med Sci Sports, 2015, 25(3): 1-72.
[8]	DALGAS U, LANGESKOV-CHRISTENSEN M, STENAGER E, et al. Exercise as medicine in multiple sclerosis-time for a paradigm shift: preventive, symptomatic, and disease-modifying aspects and perspectives[J]. Curr Neurol Neurosci Rep, 2019, 19(11): 88. doi: 10.1007/s11910-019-1002-3
[9]	KJØLHEDE T, VISSING K, DALGAS U. Multiple sclerosis and progressive resistance training: a systematic review[J]. Mult Scler, 2012, 18(9): 1215-1228. doi: 10.1177/1352458512437418
[10]	CRAMER H, LAUCHE R, AZIZI H, et al. Yoga for multiple sclerosis: a systematic review and meta-analysis[J]. PLoS One, 2014, 9(11): e112414. doi: 10.1371/journal.pone.0112414
[11]	AMEDORO A, BERARDI A, CONTE A, et al. The effect of aquatic physical therapy on patients with multiple sclerosis: a systematic review and meta-analysis[J]. Mult Scler Relat Disord, 2020, 41:102022. doi: 10.1016/j.msard.2020.102022
[12]	POLMAN C H, REINGOLD S C, BANWELL B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria[J]. Ann Neurol, 2011, 69(2): 292-302. doi: 10.1002/ana.22366
[13]	MCDONALD W I, COMPSTON A, EDAN G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis[J]. Ann Neurol, 2001, 50(1): 121-127. doi: 10.1002/ana.1032
[14]	POSER C M, PATY D W, SCHEINBERG L, et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols[J]. Ann Neurol, 1983, 13(3): 227-231. doi: 10.1002/ana.410130302
[15]	World Health Organization. International Classification of Functioning, Disability and Health: ICF[R]. Geneva: World Health Organization, 2001.
[16]	HIGGINS J P T, GREEN S. Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0)[EB/OL]. [2021-06-01]. https://www.cochrane-handbook.org.
[17]	MAHER C G, SHERRINGTON C, HERBERT R D, et al. Reliability of the PEDro scale for rating quality of randomized controlled trials[J]. Phys Ther, 2003, 83(8): 713-721. doi: 10.1093/ptj/83.8.713
[18]	GUYATT G H, OXMAN A D, VIST G E, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations[J]. BMJ, 2008, 336(7650): 924-926. doi: 10.1136/bmj.39489.470347.AD
[19]	COHEN J. Statistical Power Analysis for the Behavioral Sciences[M]. 2nd ed. Hillsdale: Erlbaum, 1988: 564-569.
[20]	FAUL F, ERDFELDER E, BUCHNER A, et al. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses[J]. Behav Res Methods, 2009, 41(4): 1149-1160. doi: 10.3758/BRM.41.4.1149
[21]	KURTZKE J F. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS)[J]. Neurology, 1983, 33(11): 1444-1452. doi: 10.1212/WNL.33.11.1444
[22]	VAN DEN BERG M, DAWES H, WADE D T, et al. Treadmill training for individuals with multiple sclerosis: a pilot randomised trial[J]. J Neurol Neurosurg Psychiatry, 2006, 77(4): 531-533. doi: 10.1136/jnnp.2005.064410
[23]	SUTHERLAND G, ANDERSEN M B, STOOVÉ M A. Can aerobic exercise training affect health-related quality of life for people with multiple sclerosis?[J]. J Sport Exerc Psychol, 2001, 23(2): 122-135. doi: 10.1123/jsep.23.2.122
[24]	BRIKEN S, GOLD S M, PATRA S, et al. Effects of exercise on fitness and cognition in progressive MS: a randomized, controlled pilot trial[J]. Mult Scler, 2014, 20(3): 382-390. doi: 10.1177/1352458513507358
[25]	HEINE M, VERSCHUREN O, HOOGERVORST E L J, et al. Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial[J]. Mult Scler, 2017, 23(11): 1517-1526. doi: 10.1177/1352458517696596
[26]	SKJERBAEK A, NAESBY M, LUTZEN K, et al. Endurance training is feasible in severely disabled patients with progressive multiple sclerosis[J]. Mult Scler, 2014, 20(5): 627-630. doi: 10.1177/1352458513505351
[27]	MOSTERT S, KESSELRING J. Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis[J]. Mult Scler, 2002, 8(2): 161-168. doi: 10.1191/1352458502ms779oa
[28]	SCHULZ K H, GOLD S M, WITTE J, et al. Impact of aerobic training on immune-endocrine parameters, neurotrophic factors, quality of life and coordinative function in multiple sclerosis[J]. J Neurol Sci, 2004, 225(1-2): 11-18. doi: 10.1016/j.jns.2004.06.009
[29]	PETAJAN J H, GAPPMAIER E, WHITE A T, et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis[J]. Ann Neurol, 1996, 39(4): 432-441. doi: 10.1002/ana.410390405
[30]	OKEN B S, KISHIYAMA S, ZAJDEL D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis[J]. Neurology, 2004, 62(11): 2058-2064. doi: 10.1212/01.WNL.0000129534.88602.5C
[31]	HEBERT J R, CORBOY J R, MANAGO M M, et al. Effects of vestibular rehabilitation on multiple sclerosis-related fatigue and upright postural control: a randomized controlled trial[J]. Phys Ther, 2011, 91(8): 1166-1183. doi: 10.2522/ptj.20100399
[32]	AHMADI A, ARASTOO A A, NIKBAKHT M, et al. Comparison of the effect of 8 weeks aerobic and yoga training on ambulatory function, fatigue and mood status in MS patients[J]. Iran Red Crescent Med J, 2013, 15(6): 449-454.
[33]	BAHMANI D S, RAZAZIAN N, FARNIA V, et al. Compared to an active control condition, in persons with multiple sclerosis two different types of exercise training improved sleep and depression, but not fatigue, paresthesia, and intolerance of uncertainty[J]. Mult Scler Relat Disord, 2019, 36: 101356. doi: 10.1016/j.msard.2019.07.032
[34]	HOGAN N, KEHOE M, LARKIN A, et al. the effect of community exercise interventions for people with MS who use bilateral support for gait[J]. Mult Scler Int, 2014, 2014: 109142.
[35]	CALLESEN J, CATTANEO D, BRINCKS J, et al. How do resistance training and balance and motor control training affect gait performance and fatigue impact in people with multiple sclerosis? A randomized controlled multi-center study[J]. Mult Scler, 2020, 26(11): 1420-1432. doi: 10.1177/1352458519865740
[36]	DALGAS U, STENAGER E, JAKOBSEN J, et al. Fatigue, mood and quality of life improve in MS patients after progressive resistance training[J]. Mult Scler, 2010, 16(4): 480-490. doi: 10.1177/1352458509360040
[37]	DODD K J, TAYLOR N F, SHIELDS N, et al. Progressive resistance training did not improve walking but can improve muscle performance, quality of life and fatigue in adults with multiple sclerosis: a randomized controlled trial[J]. Mult Scler, 2011, 17(11): 1362-1374. doi: 10.1177/1352458511409084
[38]	CAKT B D, NACIR B, GENç H, et al. Cycling progressive resistance training for people with multiple sclerosis: a randomized controlled study[J]. Am J Phys Med Rehabil, 2010, 89(6): 446-457. doi: 10.1097/PHM.0b013e3181d3e71f
[39]	CARTER A, DALEY A, HUMPHREYS L, et al. Pragmatic intervention for increasing self-directed exercise behaviour and improving important health outcomes in people with multiple sclerosis: a randomised controlled trial[J]. Mult Scler, 2014, 20(8): 1112-1122. doi: 10.1177/1352458513519354
[40]	ESCUDERO-URIBE S, HOCHSPRUNG A, HEREDIA-CAMACHO B, et al. Effect of training exercises incorporating mechanical devices on fatigue and gait pattern in persons with relapsing-remitting multiple sclerosis[J]. Physiother Can, 2017, 69(4): 292‐302.
[41]	LEARMONTH Y C, PAUL L, MILLER L, et al. The effects of a 12-week leisure centre-based, group exercise intervention for people moderately affected with multiple sclerosis: a randomized controlled pilot study[J]. Clin Rehabil, 2012, 26(7): 579-593. doi: 10.1177/0269215511423946
[42]	LEARMONTH Y C, ADAMSON B C, KINNETT-HOPKINS D, et al. Results of a feasibility randomised controlled study of the guidelines for exercise in multiple sclerosis project[J]. Contemp Clin Trials, 2017, 54: 84-97. doi: 10.1016/j.cct.2016.11.012
[43]	NEGAHBAN H, REZAIE S, GOHARPEY S. Massage therapy and exercise therapy in patients with multiple sclerosis: a randomized controlled pilot study[J]. Clin Rehabil, 2013, 27(12): 1126-1136. doi: 10.1177/0269215513491586
[44]	OZKUL C, GUCLU-GUNDUZ A, IRKEC C, et al. Effect of combined exercise training on serum brain-derived neurotrophic factor, suppressors of cytokine signaling 1 and 3 in patients with multiple sclerosis[J]. J Neuroimmunol, 2018, 316: 121-129. doi: 10.1016/j.jneuroim.2018.01.002
[45]	OZKUL C, GUCLU-GUNDUZ A, YAZICI G, et al. Effect of immersive virtual reality on balance, mobility, and fatigue in patients with multiple sclerosis: a single-blinded randomized controlled trial[J]. Eur JIntegr Med, 2020, 35: 101092.
[46]	SANGELAJI B, NABAVI S M, ESTEBSARI F, et al. Effect of combination exercise therapy on walking distance, postural balance, fatigue and quality of life in multiple sclerosis patients: a clinical trial study[J]. Iran Red Crescent Med J, 2014, 16(6): e17173.
[47]	TARAKCI E, YELDAN I, HUSEYINSINOGLU B E, et al. Group exercise training for balance, functional status, spasticity, fatigue and quality of life in multiple sclerosis: a randomized controlled trial[J]. Clin Rehabil, 2013, 27(9): 813-822. doi: 10.1177/0269215513481047
[48]	朱琳, 宋为群, 岳月红, 等. 多发性硬化缓解期患者康复治疗神经功能和疲劳度恢复的疗效观察[J]. 中国康复医学杂志, 2011, 26(9): 807-810, 817.
	ZHU L, SONG W Q, YUE Y H, et al. Observation on the efficacy of rehabilitation on recovery of neurofunction and fatigue of patients with multiple sclerosis during remitting period[J]. Chin J Rehabil Med, 2011, 26(9): 807-810, 817.
[49]	GARRETT M, HOGAN N, LARKIN A, et al. Exercise in the community for people with minimal gait impairment due to MS: an assessor-blind randomized controlled trial[J]. Mult Scler, 2013, 19(6): 782-789. doi: 10.1177/1352458512461966
[50]	OZDOGAR A T, ERTEKIN O, KAHRAMAN T, et al. Effect of video-based exergaming on arm and cognitive function in persons with multiple sclerosis: a randomized controlled trial[J]. Mult Scler Relat Disord, 2020, 40: 101966. doi: 10.1016/j.msard.2020.101966
[51]	YOUNG H J, MEHTA T S, HERMAN C, et al. The effects of M2M and adapted yoga on physical and at check for updates psychosocial outcomes in people with multiple sclerosis[J]. Arch Phys Med Rehabil, 2019, 100(3): 391-400. doi: 10.1016/j.apmr.2018.06.032
[52]	FEYS P, MOUMDJIAN L, VAN HALEWYCK F, et al. Effects of an individual 12-week community-located "start-to-run" program on physical capacity, walking, fatigue, cognitive function, brain volumes, and structures in persons with multiple sclerosis[J]. Mult Scler, 2017, 25(1): 92-103. doi: 10.1177/1352458517740211
[53]	GEDDES E L, COSTELLO E, RAIVEL K, et al. The effects of a twelve-week home walking program on cardiovascular parameters and fatigue perception of individuals with multiple sclerosis: a pilot study[J]. Cardiopulm Phys Ther J, 2009, 20(1): 5-12.
[54]	STRAUDI S, MARTINUZZI C, PAVARELLI C, et al. A task-oriented circuit training in multiple sclerosis: a feasibility study[J]. BMC Neurol, 2014, 14(1): 124. doi: 10.1186/1471-2377-14-124
[55]	BRICHETTO G, SPALLAROSSA P, DE CARVALHO M L L, et al. The effect of Nintendo Wii on balance in people with multiple sclerosis: a pilot randomized control study[J]. Mult Scler, 2013, 19(9): 1219‐1221.
[56]	BURSCHKA J M, KEUNE P M, OY U H, et al. Mindfulness-based interventions in multiple sclerosis: beneficial effects of Tai Chi on balance, coordination, fatigue and depression[J]. BMC Neurol, 2014, 14: 165. doi: 10.1186/s12883-014-0165-4
[57]	CASTRO-SANCHEZ A M, MATARAN-PENARROCHA G A, LARA-PALOMO I, et al. Hydrotherapy for the treatment of pain in people with multiple sclerosis: a randomized controlled trial[J]. Evid Based Complement Alternat Med, 2012, 2012: 473963.
[58]	EFTEKHARI E, ETEMADIFAR M. Impact of clinical mat pilates on body composition and functional indices in female patients with multiple sclerosis[J]. Crescent J Med Biol, 2018, 5(4): 297‐305.
[59]	KALRON A, ROSENBLUM U, FRID L, et al. Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: a randomized controlled trial[J]. Clin Rehabil, 2017, 31(3): 319-328. doi: 10.1177/0269215516637202
[60]	KOOSHIAR H, MOSHTAGH M, SARDAR M A, et al. Fatigue and quality of life of women with multiple sclerosis: a randomized controlled clinical trial[J]. J Sports Med Phys Fitness, 2015, 55(6): 668-674.
[61]	RAZAZIAN N, YAVARI Z, FARNIA V, et al. Exercising impacts on fatigue, depression, and paresthesia in female patients with multiple sclerosis[J]. Med Sci Sports Exerc, 2016, 48(5): 796-803.
[62]	YAZGAN Y Z, TARAKCI E, TARAKCI D, et al. Comparison of the effects of two different exergaming systems on balance, functionality, fatigue, and quality of life in people with multiple sclerosis: a randomized controlled trial[J]. Mult Scler Relat Disord, 2020, 39: 101092.
[63]	KLAREN R E, MOTL R W, DLUGONSKI D, et al. Objectively quantified physical activity in persons with multiple sclerosis[J]. Arch Phys Med Rehabil, 2013, 94(12): 2342-2348. doi: 10.1016/j.apmr.2013.07.011
[64]	KLAREN R E, SASAKI J E, MCAULEY E, et al. Patterns and predictors of change in moderate-to-vigorous physical activity over time in multiple sclerosis[J]. J Phys Act Health, 2017, 14(3): 183-188. doi: 10.1123/jpah.2016-0335
[65]	KALB R, BROWN T R, COOTE S, et al. Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course[J]. Mult Scler, 2020, 26(12): 1459-1469. doi: 10.1177/1352458520915629
[66]	LEARMONTH Y C, MOTL R W. Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences[J]. Disabil Rehabil, 2016, 38(13): 1227-1242. doi: 10.3109/09638288.2015.1077397
[67]	KIM Y, MEHTA T, LAI B, et al. Immediate and sustained effects of interventions for changing physical activity in people with multiple sclerosis: meta-analysis of randomized controlled trials[J]. Arch Phys Med Rehabil, 2020, 101(8): 1414-1436. doi: 10.1016/j.apmr.2020.03.017
[68]	SUH Y, WEIKERT M, DLUGONSKI D, et al. Social cognitive variables as correlates of physical activity in persons with multiple sclerosis: findings from a longitudinal, observational study[J]. Behav Med, 2011, 37(3): 87-94. doi: 10.1080/08964289.2011.603768
[69]	ROONEY S, WOOD L, MOFFAT F, et al. Is fatigue associated with aerobic capacity and muscle strength in people with multiple sclerosis: a systematic review and meta-analysis[J]. Arch Phys Med Rehabil, 2019, 100(11): 2193-2204. doi: 10.1016/j.apmr.2019.06.014
[70]	MOTL R W, SANDROFF B M, SUH Y, et al. Energy cost of walking and its association with gait parameters, daily activity, and fatigue in persons with mild multiple sclerosis[J]. Neurorehabil Neural Repair, 2012, 26(8): 1015-1021. doi: 10.1177/1545968312437943
[71]	MOKHTARZADE M, RANJBAR R, MAJDINASAB N, et al. Effect of aerobic interval training on serum IL-10, TNFα, and adipokines levels in women with multiple sclerosis: possible relations with fatigue and quality of life[J]. Endocrine, 2017, 57(2): 262‐271.
[72]	GOLZARI Z, SHABKHIZ F, SOUDI S, et al. Combined exercise training reduces IFN-γ and IL-17 levels in the plasma and the supernatant of peripheral blood mononuclear cells in women with multiple sclerosis[J]. Int Immunopharmacol, 2010, 10(11): 1415-1419. doi: 10.1016/j.intimp.2010.08.008

结局指标	降级因素					证据质量
结局指标	偏倚风险	不一致性	间接性	不精确性	发表偏倚	证据质量
总体效应	0	-1	0	0	0	+++-中
有氧	0	0	0	0	0	++++高
抗阻	0	0	0	-1	0	+++-中
混合	0	-1	0	0	0	+++-中
任务导向	0	0	-1	-1	0	++--低
其他	0	-1	-1	0	0	++--低

运动干预对多发性硬化患者疲劳症状影响的Meta分析

Effects of exercise intervention on fatigue for patients with multiple sclerosis: a meta-analysis

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 4

参考文献 72

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	刘华, 王丽媛, 马欣, 李静, 王丽. 基于OBE-CDIO模式运动康复训练教程课程改革的效果[J]. 《中国康复理论与实践》, 2026, 32(3): 270-275.
[2]	王志伟, 孟丽君, 武雨, 刘健, 达朝锦, 延泽萍, 吴世彩. 全膝关节置换术后患者疼痛、运动恐惧、社会参与与膝关节功能的关系：基于伦理公平性视角下的网络分析[J]. 《中国康复理论与实践》, 2026, 32(3): 364-372.
[3]	中国康复医学会康复医学教育专业委员会运动康复学组, 钱菁华, 廖远朋, 王琳, 张秋霞, 保文莉, 张海峰. 基于世界卫生组织康复胜任力架构构建运动康复本科专业实习体系[J]. 《中国康复理论与实践》, 2026, 32(2): 241-248.
[4]	陈健, 李哲恒, 王定宣. 基于世界卫生组织康复胜任力架构的中国运动康复专业人才培养现状分析[J]. 《中国康复理论与实践》, 2026, 32(1): 110-116.
[5]	吴澄, 章云枫, 王卫宁, 余克威, 张艳正, 沈嘉蓉, 吴毅. 肘腕功能支具对脑卒中偏瘫患者足底压力和平衡功能的效果[J]. 《中国康复理论与实践》, 2026, 32(1): 30-39.
[6]	魏婧怡, 王潇婧, 王冉, 卫晨, 马赛, 刘西花. 针刺同步言语训练对卒中后运动性失语患者的效果[J]. 《中国康复理论与实践》, 2025, 31(9): 1000-1008.
[7]	高云汉, 侯闪闪, 汪鑫煜, 朱崇田. 基于功能性近红外光谱探讨脑机接口对脑卒中患者上肢运动功能障碍的效果[J]. 《中国康复理论与实践》, 2025, 31(9): 1066-1073.
[8]	苏本跃, 刘文瑶, 宗文杰, 王保乾, 盛敏. 基于自适应时序对齐的智能下肢假肢运动意图识别[J]. 《中国康复理论与实践》, 2025, 31(9): 1101-1115.
[9]	叶绿, 陈悦琳, 刘雨霏. 儿童身体活动与脑健康的认知神经科学研究技术范式与进展：Scoping综述[J]. 《中国康复理论与实践》, 2025, 31(8): 889-895.
[10]	王晓锋, 胡梦巧, 汪嫣, 魏坤, 徐文竹, 任丹, 马晔. 外骨骼机器人辅助步态训练对脑卒中和脊髓损伤下肢功能康复效果的系统综述[J]. 《中国康复理论与实践》, 2025, 31(8): 914-921.
[11]	吕雪琴, 张通, 刘惠林, 刘建华, 李达, 王华伟. 术前运动对脑室-腹腔分流术患者的效果[J]. 《中国康复理论与实践》, 2025, 31(8): 958-964.
[12]	杜雯倩, 张旭, 陈继伟, 王兴, 朱昆. 运动干预对帕金森病冻结步态效果的Meta分析[J]. 《中国康复理论与实践》, 2025, 31(7): 781-789.
[13]	孙婉婷, 艾丽皮乃·亚森, 龚翔, 肖悦, 甘兆丹, 刘铭洁, 曾兰婷, 马姝玥, 鲁俊, 许光旭. 基于运动序列学习探讨高频重复经颅磁刺激对脑卒中患者上肢功能的效果[J]. 《中国康复理论与实践》, 2025, 31(7): 812-821.
[14]	唐丽, 戈晓珍, 刘杰, 张焱, 王金荣, 左雪冰, 王国栋. 冠状动脉临界病变患者心肺能力与运动后心率恢复的相关性[J]. 《中国康复理论与实践》, 2025, 31(7): 838-845.
[15]	刘璇, 高玲, 褚凤明, 陈杰, 张明. 脑机接口联合上肢康复机器人对脑卒中患者上肢功能的影响[J]. 《中国康复理论与实践》, 2025, 31(6): 703-710.