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Exercise Interventions for Improving Flexibility in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis

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Research Group DEPORSALUD (Physical Activity and Health, Studies in Sports Performance, Disability and Gender), Faculty of Sports Sciences, University of Castilla La-Mancha, A Carlos III s/n, E-45071 Toledo, Spain
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HealthyFit Research Group, Department of Special Didactics, Faculty of Educational Sciences and Sports, University of Vigo, Campus A Xunqueira s/n, E-36005 Pontevedra, Spain
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Faculty of Education and Sport Science, University of Vigo, E-36005 Pontevedra, Spain
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VALFIS Research Group, Institute of Biomedicine (IBIOMED), Faculty of Physical Activity and Sports Sciences, University of León, 24071 León, Spain
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Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria. Ctra Pozuelo a Majadahonda 11-515 KM 1.800, 28223 Pozuelo de Alarcón, Madrid, Spain
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Well-Move Research Group, Department of Special Didactics, Faculty of Educational Sciences and Sports, University of Vigo, Campus A Xunqueira s/n, E-36005 Pontevedra, Spain
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Author to whom correspondence should be addressed.
Medicina 2019, 55(11), 726; https://doi.org/10.3390/medicina55110726
Received: 16 October 2019 / Revised: 27 October 2019 / Accepted: 30 October 2019 / Published: 2 November 2019
Background and objectives: People with multiple sclerosis (MS) often experience limitations in joint range of motion, which is linked to spasticity and continued inactivity. Low flexibility levels in this population have been linked to postural problems and muscular pain. Therefore, the purpose of this study was to conduct a systematic review and a meta-analysis aimed at identifying the characteristics and methodological quality of investigations studying the effects of exercise interventions on the flexibility levels of people with MS. Materials and Methods: Three electronic databases (MEDLINE/PubMed, SPORTDiscus and Scopus) were systematically searched up to May 2019 for intervention studies focused on the effects of exercise on the flexibility levels of people with MS. A meta-analysis, including randomized controlled trials (RCT), which reported information regarding the effects of exercise on flexibility, was also conducted. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database, and the Quality Assessment Tool for Before–After Studies, with no control group. The quality of the information reported, regarding the programs conducted, was assessed by means of the Consensus on Exercise Reporting Template (CERT) scale. Results: Seven studies, four RCTs and three uncontrolled investigations were finally selected. The methodological quality of the RCTs was considered “poor” in one study, and “good” and “excellent” in two studies and one investigation, respectively. The three uncontrolled studies showed a methodological quality between “fair” and “poor”. Following the CERT scale, four studies were graded as “high” and three as “low”. Findings from the meta-analysis indicated no significant effects on hamstring flexibility, or the range of motion in the hips, knees or ankles. Conclusions: There is preliminary evidence from individual studies which indicates that people with MS can improve their lower limb flexibility following participation in physical exercise programs, but the meta-analysis did not confirm these findings. View Full-Text
Keywords: flexibility; multiple sclerosis; range of motion; stretching flexibility; multiple sclerosis; range of motion; stretching
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Torres-Pareja, M.; Sánchez-Lastra, M.A.; Iglesias, L.; Suárez-Iglesias, D.; Mendoza, N.; Ayán, C. Exercise Interventions for Improving Flexibility in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis. Medicina 2019, 55, 726.

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