The Effect of Regular Physical Activity On Some Pre-Inflammatory and Anti-Inflammatory Factors in Patients with Multiple Sclerosis: A Systematic Review Study

Today, Multiple Sclerosis (MS) is the most common neurological disease among young adults. Physical activity is mentioned as the most important factor in preventing diseases and living a healthy life. Although advances in disease-modifying drugs have helped stabilize the course of MS, which increases life expectancy, in most MS patients the symptoms worsen over time. In this regard, physical exercise programs are considered as a safe and tolerable tool. The aim of this study was to conduct a systematic review of the effects of exercise on some pro-inflammatory and anti-inflammatory factors in people with MS.

In this study, articles related to keywords were searched in PabMed, ScienceDirect, Scopus and Web of Science specialized databases in English and Jihad Daneshgahi, Mag Iran and IranDock databases in Persian. Inclusion criteria include: Persian or English language of the article, availability of the full text of the article, desired time period, evaluation of the effect of regular physical activity in patients with MS, evaluation of pro-inflammatory and anti-inflammatory factors and exclusion criteria The use of other methods and interventions, such as the use of drugs other than the usual drugs or supplements during the training period.

Out of 408 articles received from domestic and foreign databases in the last 20 years, 19 articles were reviewed after applying input and output variables. The Pedro Information Evidence Database (PEDro) scale was used to evaluate the quality of the studies. In the studied studies, aerobic or endurance exercises (6 studies), resistance (5 studies), combination (8 studies) have been used. Among inflammatory and anti-inflammatory factors, brain-derived neurotrophic factor (BDNF) in eleven studies (57.9%) and interleukin 17 (IL-17) in eight studies (42.1%) were the most widely used indices.

We conclude that although interventions such as exercise have improved the functional and clinical outcomes of patients with multiple sclerosis, these improvements may not be due solely to changes in cytokine levels or inflammatory markers. Exercise is an accessible alternative that not only does not increase inflammation or disease severity, but also helps these patients by reducing their risk of secondary disorders and restrictions on community participation.