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Review

Effects of Exercise, Rehabilitation, and Nutritional Approaches on Body Composition and Bone Density in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis

by
Natascia Rinaldo
1,†,
Alba Pasini
1,†,
Sofia Straudi
1,
Giovanni Piva
2,
Anna Crepaldi
3,4,
Andrea Baroni
1,
Lorenzo Caruso
5,
Fabio Manfredini
1 and
Nicola Lamberti
1,*
1
Department of Neuroscience and Rehabilitation, University of Ferrara, 44124 Ferrara, Italy
2
Doctoral Program in Environmental Sustainability and Wellbeing, Department of Humanities, University of Ferrara, 44121 Ferrara, Italy
3
Unit of Nephrology, University Hospital of Ferrara, 44124 Ferrara, Italy
4
Department of Nursing, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
5
Department of Environment and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Funct. Morphol. Kinesiol. 2023, 8(3), 132; https://doi.org/10.3390/jfmk8030132
Submission received: 3 August 2023 / Revised: 5 September 2023 / Accepted: 7 September 2023 / Published: 8 September 2023
(This article belongs to the Section Sports Medicine and Nutrition)
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Abstract

People with multiple sclerosis (pwMS) are affected by a wide range of disabilities, including a decrease in bone mineral density (BMD) and a worsening of body composition (BC), which negatively impact their quality of life quality. This study aims to analyze the effects of nonpharmacological interventions—in particular, physical activity, nutritional approaches, and rehabilitation—on BC and BMD in pwMS. This systematic review and meta-analysis was performed following the updated version of the PRISMA guidelines. In July 2022, five databases (MEDLINE, Embase, The Cochrane Library, Google Scholar, Web of Science) and gray literature were screened. Relevant articles published between 1 January 1990 and 1 September 2022 in any language were included. Outcomes of interest were anthropometric, BC measures, and BMD. The RoB 2.0 tool was used to assess the risk of bias. After duplicates elimination, 1120 records were screened, and 36 studies were included. A total of 25 articles were focused on physical activity and rehabilitation, 10 on nutrition, and 1 on multimodal intervention. One-third of the studies were judged to be at high risk of bias. The meta-analysis showed a high degree of heterogeneity due to the high variability in disease severity and intervention duration, intensity, frequency, and type. In general, no intervention showed consistent positive effects on BC. However, the most promising interventions seemed to be high-intensity training and ketogenic diets. Only a few studies considered BMD, and the results are inconsistent. Nevertheless, more studies are needed in order to confirm these results.
Keywords: multiple sclerosis; body composition; bone mineral density; nonpharmacological treatments; exercise and rehabilitation; nutritional interventions multiple sclerosis; body composition; bone mineral density; nonpharmacological treatments; exercise and rehabilitation; nutritional interventions
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MDPI and ACS Style

Rinaldo, N.; Pasini, A.; Straudi, S.; Piva, G.; Crepaldi, A.; Baroni, A.; Caruso, L.; Manfredini, F.; Lamberti, N. Effects of Exercise, Rehabilitation, and Nutritional Approaches on Body Composition and Bone Density in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis. J. Funct. Morphol. Kinesiol. 2023, 8, 132. https://doi.org/10.3390/jfmk8030132

AMA Style

Rinaldo N, Pasini A, Straudi S, Piva G, Crepaldi A, Baroni A, Caruso L, Manfredini F, Lamberti N. Effects of Exercise, Rehabilitation, and Nutritional Approaches on Body Composition and Bone Density in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis. Journal of Functional Morphology and Kinesiology. 2023; 8(3):132. https://doi.org/10.3390/jfmk8030132

Chicago/Turabian Style

Rinaldo, Natascia, Alba Pasini, Sofia Straudi, Giovanni Piva, Anna Crepaldi, Andrea Baroni, Lorenzo Caruso, Fabio Manfredini, and Nicola Lamberti. 2023. "Effects of Exercise, Rehabilitation, and Nutritional Approaches on Body Composition and Bone Density in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis" Journal of Functional Morphology and Kinesiology 8, no. 3: 132. https://doi.org/10.3390/jfmk8030132

APA Style

Rinaldo, N., Pasini, A., Straudi, S., Piva, G., Crepaldi, A., Baroni, A., Caruso, L., Manfredini, F., & Lamberti, N. (2023). Effects of Exercise, Rehabilitation, and Nutritional Approaches on Body Composition and Bone Density in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis. Journal of Functional Morphology and Kinesiology, 8(3), 132. https://doi.org/10.3390/jfmk8030132

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