阻力訓練於多發性硬化症疲憊成效──系統性文獻回顧

Effectiveness of Resistance Training on Multiple Sclerosis-Related Fatigue: A Systematic Review

背景：多發性硬化症病人普遍有肌肉適能不足、疲憊困擾，運動可保持肌肉適能與改善疲憊，阻力訓練為建議之一，然其運動方案多元且結果尚無一致定論，需實證綜整其成效。
目的：綜整阻力訓練於多發性硬化症之肌肉適能與疲憊改善成效。
方法：系統性文獻回顧，於2024年3月搜尋五個中英文資料庫，以多發性硬化症、阻力訓練、疲憊為關鍵字串，限制隨機對照試驗（randomized controlled trial, RCT）文獻，經篩選共5篇文獻納入評讀，以Joanna Briggs Institute之RCT嚴格評讀工具進行文獻品質評析。
結果：五篇RCT分別為高強度、快速向心、高強度離心及呼吸肌之阻力訓練，結果顯示阻力訓練有較佳的肌力、耐力、最大吸氣壓力與最大呼氣壓力等肌肉適能表現及疲憊改善，但僅部分達統計顯著差異。
結論／實務應用：阻力訓練有較佳的肌肉適能提升及疲憊改善，但僅部分有統計顯著差異。受限於現有研究篇數少、樣本小，阻力訓練運動方案多元等限制，證據力尚顯薄弱。建議未來需有更多相關研究加入，再做更新的系統性文獻回顧，臨床可考慮將阻力訓練納入多發性硬化症病人運動建議之一，但須追蹤病人執行成效。

Background: Patients with multiple sclerosis (MS) often experience impaired muscular fitness and fatigue. Exercise
is known to help maintain muscle fitness and alleviate fatigue, with resistance training being recommended as a
potential intervention. However, due to the variety of resistance exercises used and inconsistencies in the results obtained, an evidence-based systematic review is needed to synthesize the effectiveness of this intervention.
Purpose: This study was designed to synthesize the current research on the effectiveness of resistance training in improving muscle fitness and reducing fatigue in patients with MS.
Methods: A systematic review was conducted in March 2024, with five English and Chinese databases searched using keywords related to MS, resistance training, and fatigue. Only randomized controlled trials (RCTs) were included, and a total of five studies met the inclusion criteria. A quality appraisal of the included studies was performed using the Joanna Briggs Institute’s critical appraisal tool for evaluating RCTs.
Results: The five RCTs included in this systematic review examined different resistance training protocols, including high-intensity, fast-velocity concentric, high-intensity eccentric, and respiratory muscle resistance training. Overall, the results indicate resistance training led to better muscular fitness improvements in terms of muscle strength, endurance, maximal inspiratory pressure, maximal expiratory pressure, and fatigue reduction. However, statistical significance was achieved in only some of the studies.
Conclusion/Implications for Practice: Resistance training appears to be beneficial in improving muscle fitness and reducing fatigue in patients with MS, even though only some of the studies achieved statistical significance. The current evidence is weak due to the limited number of published studies and the small sample sizes and diversity in training protocols used. Further systematic reviews are needed to update findings as more research becomes available. Clinically, resistance training may be considered as part of exercise recommendations for MS patients, and outcomes should be monitored.