Changes in walking speed following resistance training in people with multiple sclerosis: A systematic review and meta-analysis

Background: Reduced walking ability, especially decreased gait speed, is one of the most common and disabling impairments reported by people with multiple sclerosis (MS). Considering the impact of muscle strength on walking ability, resistance training may have the potential to improve walking speed in MS. Therefore, this systematic review and meta-analysis aims to evaluate the effect of lower limb resistance training on walking speed in people with MS. Methods: Seven databases (CINAHL, MEDLINE, The Allied and Complimentary Medicine Database, Web of Science, Physiotherapy Evidence Database [PEDro], PsycINFO, and Sports Medicine and Education Index) were searched in March 2024 for studies that met the following eligibility criteria: randomized controlled trials investigating the effects of resistance training interventions on objective measures of walking speed in people with MS. Risk of bias was assessed using the PEDro scale. Meta-analysis was performed to quantify intervention effect using a random effects model. Results: Twelve randomized controlled trials were included, reporting data on 425 individuals with MS. Participants had mostly relapsing-remitting MS (85%) and a mild-moderate level of disability (Expanded Disability Status Score 1.0-6.0). Results of the meta-analysis (based on 7 of the included studies) indicated a significant yet variable improvement in walking speed in favor of the intervention (0.10 m/s, 95% confidence interval 0.01-0.19, p < .05). Sensitivity analysis indicates that larger improvements in walking speed were found over tests covering shorter distances. Conclusions: Resistance training was found to significantly improve walking speed in people with MS. However, variability in results were noted across studies; accordingly, future research should determine how variables-particularly related to resistance training prescription-influence the intervention effect.