The effect of resistance training on quality of life in people with multiple sclerosis : A systematic review, meta-analysis, and meta-regression

Ashworth, Hannah and Sanal-Hayes, Nilihan EM and Sculthorpe, Nicholas F and Hendrickse, Paul W and Gaffney, Christopher J and Chan, Ainsley M and Hayes, Lawrence D (2026) The effect of resistance training on quality of life in people with multiple sclerosis : A systematic review, meta-analysis, and meta-regression. The American Journal of Medicine. ISSN 0002-9343 (In Press)

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Abstract

Background Multiple sclerosis is a chronic autoimmune condition that impairs quality of life. While disease-modifying therapies are the primary treatment, resistance training has emerged as a non-pharmacological intervention to enhance both physical and mental health aspects of quality of life. Objective This systematic review and meta-analysis evaluated effects of resistance training on physical and mental health components of quality of life, as well as overall quality of life, in people with multiple sclerosis. Methods A comprehensive literature search was conducted across Scopus, Medline, and SPORTDiscus to identify randomized and non-randomized trials assessing the impact of resistance training on quality of life in people with multiple sclerosis. Data from 13 studies were synthesized with random-effects meta-analyses. Results Resistance training improved overall quality of life (standardized mean difference = 1.25; 95% confidence interval: 0.03 to 2.47, p=0.045), physical health (standardized mean difference = 0.29; 95% confidence interval: 0.05 to 0.53, p=0.017), and mental health (standardized mean difference = 0.23; 95% confidence interval: −0.11 to 0.56, p=0.184). No association was found between study duration and effect size in the meta-regression. Conclusions Resistance training shows potential to improve quality of life in individuals with multiple sclerosis, particularly in physical and mental health domains. However, the effects were inconsistent and not statistically significant for mental health. Further high-quality, standardized, and adequately powered trials are needed to confirm these findings and inform clinical practice.