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    Effect of Exercise Interventions on Anxiety in People with Multiple Sclerosis: A Systematic Review and Meta-analysis.

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    Author
    Gascoyne, C; Karahalios, A; Demaneuf, T; Marck, C
    Date
    2020-05
    Source Title
    International Journal of MS Care
    Publisher
    Consortium of Multiple Sclerosis Centers
    University of Melbourne Author/s
    Marck, Claudia; Karahalios, Amalia
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
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    Document Type
    Journal Article
    Citations
    Gascoyne, C., Karahalios, A., Demaneuf, T. & Marck, C. (2020). Effect of Exercise Interventions on Anxiety in People with Multiple Sclerosis: A Systematic Review and Meta-analysis.. Int J MS Care, 22 (3), pp.103-109. https://doi.org/10.7224/1537-2073.2019-009R.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254241
    DOI
    10.7224/1537-2073.2019-009R
    Open Access URL
    http://doi.org/10.7224/1537-2073.2019-009R
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307872
    NHMRC Grant code
    NHMRC/1120014
    Abstract
    Background: Evidence suggests that exercise can alleviate symptoms associated with multiple sclerosis (MS). However, it is unclear whether exercise alleviates symptoms of anxiety, present in one-third of people with MS. This systematic review and meta-analysis investigates whether exercise interventions are effective in reducing anxiety in people with MS. Methods: CINAHL, Embase, MEDLINE, PsycINFO, and the Cochrane Controlled Clinical Trials Register were searched to identify relevant randomized controlled trials (RCTs) published up to March 30, 2018. The primary outcome was postintervention difference in anxiety scores between intervention and control groups. Using a restricted maximum likelihood random-effects model, standardized mean differences were pooled and heterogeneity was estimated. Risk of bias was assessed using an a priori modified Cochrane Risk of Bias 2.0 tool. Results: Four RCTs with 133 participants were included. Exercise type included walking, aerobic activities, and cycling. Intervention duration ranged from 8 to 26 weeks. The pooled standardized mean difference in anxiety score was -0.16 (95% CI, -0.50 to 0.19), without heterogeneity. Two studies had high risk of bias, and two had some risk of bias. Conclusions: Based on available RCT data, exercise does not seem to have an effect on anxiety in people with MS. These results should be interpreted with caution because studies had concerns of bias and small sample sizes, and anxiety was not the primary outcome measure. Future studies should exhibit sufficient reporting standards, alongside publishing protocols. There is opportunity to investigate the effect of exercise in people with MS experiencing clinically relevant levels of anxiety rather than in the general MS population.

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