Effects of physical exercise on spasticity in people with multiple sclerosis: A systematic review.

In 30 seconds

This systematic review examined whether physical exercise reduces spasticity in people with multiple sclerosis (MS). It included 13 randomised controlled trials enrolling participants with EDSS scores ≤6.0 and synthesised results narratively across resistance, flexibility, neuromotor, aerobic, alternative-modality, and multicomponent programmes. Exercise interventions were generally associated with reduced spasticity, with the most consistent improvements reported in programmes including flexibility or range-of-motion work. However, substantial variation in protocols and concerns about the sensitivity of some outcome measures limit confidence in the size and clinical significance of the effects.

Key findings

• The review included 13 randomised controlled trials of exercise interventions in people with MS and EDSS scores ≤6.0.
• Across intervention types, exercise was generally associated with reductions in spasticity.
• Improvements were most consistently reported in programmes incorporating flexibility or range-of-motion work.

Why it matters

Spasticity can affect quality of life in MS, and this review suggests exercise may be a useful non-pharmacological approach for ambulatory patients. The findings also indicate that intervention content matters: flexibility and range-of-motion components featured in the most consistent improvements. Interpreting the evidence requires caution because protocols and measurement approaches varied.

What to keep in mind

Intervention protocols varied substantially, training dose was incompletely reported, and some commonly used spasticity measures may not detect clinically meaningful change.