Is Aerobic or Resistance Training the Most Effective Exercise Modality for Improving Lower Extremity Physical Function and Perceived Fatigue in People With Multiple Sclerosis? A Systematic Review and Meta-analysis.

Researchers wanted to know whether aerobic exercise or strength training works better for people with multiple sclerosis who struggle with walking ability and tiredness. They searched nine medical databases and analyzed 22 randomized controlled trials involving nearly 1000 people, comparing aerobic training in 14 studies against resistance training in 8 studies. Both types of exercise produced similar small improvements in walking tests and fatigue levels.

The authors found no clear winner between the two approaches, suggesting that either one can be effective for these particular outcomes.

A team of researchers looked at studies comparing two common types of exercise for people with MS: aerobic training, like walking or cycling, and resistance training, like using weights or bands. They found that both approaches led to similar small improvements in how far and how quickly people could walk, and both also seemed to reduce the feeling of exhaustion that many people with MS experience. The good news is that this means you have options.

If one type of exercise appeals to you more than the other, the evidence suggests it can still work. The less clear news is that the studies they reviewed didn't measure enough other things, like how well people could manage stairs or daily activities, so it is not entirely certain how these exercises help beyond walking and fatigue.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review synthesized data from 22 RCTs to compare the effects of aerobic and resistance training on lower limb function and fatigue in people with MS. Both modalities produced small but comparable effect sizes on short walk tests and long walk tests, with confidence intervals that overlapped substantially.

For fatigue reduction, aerobic training showed an effect size of around 0.61 while resistance training showed around 0.41, both in the small-to-moderate range and both with wide confidence intervals that crossed zero. The heterogeneity in study quality and outcome measurement limits the strength of these conclusions. The authors themselves note that findings on other functional mobility measures and self-reported walking were sparse and inconclusive, highlighting a real gap in the evidence base.

This suggests that while both modalities appear safe and somewhat beneficial for the outcomes measured, the field would benefit from more rigorous head-to-head comparisons and standardized outcome batteries across MS exercise studies.