International Journal For Multidisciplinary Research

E-ISSN: 2582-2160   •   Impact Factor: 9.24

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Therapeutic Role of Exercise in Multiple Sclerosis: A Narrative Review on Fatigue, Strength, and Quality of Life

Author(s) Dr. Shashwat Darshan Joshi, Dr. Swetal Patel, Dr. Suman Yadav, Prof. Priyaranjan Chaudhary
Country India
Abstract Background:
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that leads to a great deterioration in the quality of life. Exercise studies including only fatigued persons with multiple sclerosis (PwMS) with fatigue as primary endpoint are lacking. Studies like High-intensity resistance training, powerball® system on muscle fatigue, Transcranial Direct Current Stimulation and Exercise on Fatigue, agility- based exercise training -may help address these challenges.

Objective:
To review and synthesize evidence from 2021–2025 on physiotherapy-based interventions for managing fatigue in individuals with multiple sclerosis (MS), with a focus on the effectiveness, safety, feasibility, functional outcomes, and adherence to various exercise and rehabilitation approaches.

Methods:
A narrative review was conducted following systematic search principles across PubMed, PEDro, Web of Science, and Scopus for studies published from 2021 to 2025. Studies were included if they investigated physiotherapy-based interventions targeting fatigue management in individuals with multiple sclerosis (MS), including randomized controlled trials (RCTs), feasibility studies, and pilot studies. Eligible interventions included physiotherapist-supervised exercise programs such as endurance training, resistance training, and other rehabilitation approaches aimed at reducing fatigue. Methodological quality of the included studies was assessed using an appropriate critical appraisal tool. A total of relevant studies meeting the inclusion criteria were reviewed and synthesized for analysis.
Results
All studies reported significant improvements following exercise-based interventions in individuals with multiple sclerosis. Blood flow restriction and combined training improved muscle strength, fatigue, physical activity, and quality of life. Multimodal agility training showed physical and psychological benefits without increased fatigue. tDCS combined with exercise enhanced quality of life and reduced fatigue in over half of participants. Powerball® training improved upper limb coordination and dexterity. High-intensity resistance training significantly reduced fatigue and improved psychological outcomes compared to controls.
Conclusion
Exercise interventions are effective in improving strength, reducing fatigue, and enhancing quality of life in people with multiple sclerosis. Combined and high-intensity training, as well as adjunct therapies like tDCS, show beneficial effects and can be considered safe and effective rehabilitation strategies.
Keywords Multiple Sclerosis ; Physiotherapy ; Fatigue ; High-intensity
Field Medical / Pharmacy
Published In Volume 8, Issue 3, May-June 2026
Published On 2026-05-17
DOI https://doi.org/10.36948/ijfmr.2026.v08i03.77848
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