Updated Systematic Review and Quantitative Synthesis of Physical Activity Levels in Multiple Sclerosis

OBJECTIVE

This article provided an updated quantitative synthesis of physical activity levels in persons with multiple sclerosis compared with controls and other clinical populations.

DESIGN

A systematic search through PubMed, Scopus, and PsycINFO was conducted for articles published between August 2016 and July 2022. Articles that included a group comparison of at least one measurement of physical activity between adults with multiple sclerosis and controls or other clinical populations were included in the meta-analysis.

RESULTS

Twenty-four studies met the inclusion criteria and yielded a total of 119 comparisons. There was a moderate difference in physical activity levels between persons with multiple sclerosis and controls (effect size = -0.56, P < 0.01), but no significant difference between persons with multiple sclerosis and other clinical populations (effect size = 0.01, P = 0.90). The pooled effect sizes comparing multiple sclerosis with controls ( Q104 = 457.9, P < 0.01) as well as with clinical populations ( Q13 = 108.4, P < 0.01) were heterogeneous. Moderating variables included sex, disability status, measurement method, outcome, intensity, and application of a multiple sclerosis-specific cut-point.

CONCLUSIONS

Physical activity levels remain significantly lower in persons with multiple sclerosis compared with controls, but the magnitude of difference has become smaller over the past decade. There is a need for continued development of effective physical activity programs that can reach the greater community with multiple sclerosis.

Serum levels of immunoglobulins A, G and M in New Zealand and Tokelauan children

Serum levels of immunoglobulins A, G and M are described in a group of New Zealand (NZ) children of European descent. These findings are used as reference standards for three groups of Tokelauan children, atoll residents, migrants in NZ, and NZ-born Tokelauan children. All three Tokelauan groups had high levels of IgA, IgG, and IgM. Breast feeding was diminished and morbidity was higher in the NZ-born group. The IgG level was negatively correlated with duration of breast feeding in this group. In the atoll group IgG was related to present illness but no other consistent relationships were found between present illness status and the immunoglobulin levels. It remains unclear whether the high Tokelauan immunoglobulin levels are genetically or environmentally determined.