Effects and optimal dosage of resistance training on strength, functional capacity, balance, general health perception, and fatigue in people with multiple sclerosis: a systematic review and meta-analysis.

People living with multiple sclerosis often deal with muscle weakness, poor balance, and fatigue, and resistance training is one strategy that's been tested as a way to help. This review pooled 44 studies comparing resistance training programs against control conditions to see whether lifting weights or similar strengthening exercise actually improves strength, walking, balance, general health, and fatigue in this population. The pooled results showed statistically significant benefits for knee muscle strength, the timed up-and-go test, walking endurance, gait speed, and balance, favoring the training groups.

However, strength measured as a one-repetition maximum did not differ significantly, and neither fatigue nor general health perception showed a significant benefit, despite the paper's stated conclusion that fatigue improved. The authors also tried to pin down an optimal training dose, but the abstract describes those dosage findings as inconsistent, meaning the specific amount, intensity, and frequency needed for best results remain unclear even though some patterns emerged.

If you're living with multiple sclerosis and wondering whether strength training exercises might help, this large review looked at that exact question by combining results from 44 separate studies. The people who did structured resistance training programs, things like squats, leg presses, or similar strengthening exercises, tended to walk faster, get up and move around more easily, and balance better compared to those who didn't do this kind of training.

Their knee muscles also got measurably stronger in certain tests. That said, not every outcome improved. When strength was measured a different way, using the heaviest single weight someone could lift, there wasn't a clear difference between groups.

Fatigue levels and how people rated their overall health also didn't show a statistically significant improvement, according to the numbers reported. The researchers also tried to figure out the best amount, intensity, and frequency of training, but found the evidence on that point to be inconsistent, so no clear formula emerged.

This means resistance training shows some encouraging patterns for movement and balance, but the picture is mixed and not every benefit people might hope for was confirmed by the data.

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

This systematic review and meta-analysis pooled 44 studies examining resistance training programs in people with multiple sclerosis, assessing strength, functional capacity, balance, general health perception, and fatigue, with subgroup analysis and meta-regression used to explore dosage effects. Statistically significant between-group differences favoring resistance training were found for knee extensor strength (p=0.01), knee flexor strength (p<0.001), Timed Up and Go performance (p=0.001), walking endurance (p=0.02), gait speed (p=0.02), and balance (p=0.02).

No significant difference was detected for one-repetition maximum strength, and neither fatigue nor general health perception showed significant between-group improvement. Notably, the abstract's conclusion states that resistance training improves fatigue, which is inconsistent with the reported null result for that outcome, an internal discrepancy clinicians should weigh when interpreting the paper's summary claims. Dosage findings, despite implications suggesting longer duration (over 6 weeks), higher intensity (over 80% of one-repetition maximum), and twice-weekly frequency may be favorable, were explicitly described as inconsistent across studies.

Given the breadth of included studies and outcomes, heterogeneity in training protocols and outcome measures likely limits certainty, and the review does not report specific risk-of-bias or GRADE certainty ratings in the abstract, so confidence in dosage-specific conclusions should remain guarded.