Background. Exercise training is associated with functional improvements in persons with multiple sclerosis (MS), perhaps based on neuroplasticity. However, inferences regarding neuroplasticity require observations of exercise-related changes in the central nervous system that explain functional adaptations. This systematic review critically evaluated studies on exercise training, neuroimaging outcomes, and functional outcomes in MS based on consistency with a well-established conceptual model for characterizing exercise training as a possible neuroplasticity-inducing behavior in this population. Methods. We performed targeted and comprehensive searches of multiple databases for papers involving exercise training interventions on functional and neuroimaging outcomes in persons with MS. Acceptable study designs included randomized controlled trials, single-group pre/post designs, and quasi-experimental designs. Four independent reviewers extracted relevant data from each eligible paper on characteristics of participants, exercise interventions, neuroimaging outcomes, functional outcomes, pattern of study results, and potential risks of bias. Results. The literature search returned only 10 papers (involving 8 original interventions) that met eligibility criteria wherein inferences regarding neuroplasticity could be drawn, based on inclusion of neuroimaging and functional endpoints. Within those 10 papers, there is mixed evidence for exercise training as a neuroplasticity-inducing behavior in persons with MS. Conclusions. Such a paucity of evidence supporting exercise-induced neuroplasticity in MS is likely a product of a very small number of papers that do not sufficiently examine hypothesized mechanisms of action. Future research might consider examining specific neural changes that might result from exercise prescriptions that are specifically designed to induce certain functional changes among persons with MS.

中文翻译：

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运动训练作为多发性硬化症神经可塑性诱导行为的系统评价

背景。运动训练与多发性硬化症 (MS) 患者的功能改善有关，这可能是基于神经可塑性。然而，关于神经可塑性的推论需要观察中枢神经系统中与运动相关的变化，这些变化解释了功能适应性。这篇系统综述批判性地评估了运动训练、神经影像学结果和 MS 功能结果的研究，该研究基于与完善的概念模型的一致性，该模型将运动训练描述为该人群中可能的神经可塑性诱导行为。方法。我们对多个数据库进行了有针对性的全面搜索，以查找涉及 MS 患者功能和神经影像学结果的运动训练干预的论文。可接受的研究设计包括随机对照试验、单组前/后设计和准实验设计。四名独立审查员从每篇符合条件的论文中提取了有关参与者特征、运动干预、神经影像学结果、功能结果、研究结果模式和潜在偏倚风险的相关数据。结果。文献搜索仅返回了 10 篇符合资格标准的论文（涉及 8 项原始干预措施），其中可以基于神经影像学和功能终点的纳入得出关于神经可塑性的推论。在这 10 篇论文中，有混合的证据表明运动训练是 MS 患者的神经可塑性诱导行为。结论。如此缺乏证据支持运动诱发的多发性硬化症神经可塑性可能是极少数论文没有充分研究假设的作用机制的产物。未来的研究可能会考虑检查可能由运动处方引起的特定神经变化，这些运动处方专门设计用于诱导 MS 患者的某些功能变化。