Efficacy and safety of exercise training for treating major depressive disorder in multiple sclerosis: a systematic review and meta-analysis

BackgroundMajor depressive disorder (MDD) is highly prevalent among individuals with multiple sclerosis (MS), significantly impacting their quality of life and treatment outcomes. While pharmacological interventions have limitations, exercise training has emerged as a promising non-pharmacological approach. This review aims to review the efficacy and safety of exercise training interventions for treating MDD in MS patients. MethodsFollowing PRISMA guidelines, a systematic search of electronic databases was conducted up to May 2024. Studies assessing exercise training's effects on MDD in MS patients were included. Data extraction and quality assessment were performed independently by two reviewers, with discrepancies resolved through consensus or arbitration. ResultsTen studies (3 RCTs, 7 observational) met inclusion criteria, comprising 1174 MS patients. Meta-analysis of six studies demonstrated a moderate reduction in depression scores (Hedges's g = -0.51, 95% CI -0.70 to -0.32) favoring exercise interventions compared to controls. No significant heterogeneity was observed (I2 = 0.00%). Various exercise modalities including endurance training, Pilates, and cycling showed efficacy in reducing depressive symptoms. ConclusionThis systematic review and meta-analysis provide robust evidence supporting exercise training as a beneficial adjunctive therapy for alleviating depressive symptoms in MS patients. Healthcare providers should consider integrating exercise programs into comprehensive treatment plans for managing MDD in this population.