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The Effects of Combined Exercise Training on Tumor Necrosis Factor-Alpha and Interleukin-10 in Patients with Multiple Sclerosis: A Systematic Review and Meta-Analysis
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Abbas Saremi   , OMID ZAFARMAND1 |
| 1- , OMIDZAFARMAND2202@GMAIL.COM |
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Abstract: (22 Views) |
| Background and Aim: Multiple sclerosis (MS) is one of the most common diseases of the central nervous system, caused by the destruction of the myelin sheath. Exercise has been recognized as a practical strategy with an important role in modulating tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) levels in patients with MS; however, there is no general consensus on the most appropriate exercise program. Therefore, the present study aimed to investigate the effects of combined exercise training on TNF-α and IL-10 in patients with multiple sclerosis. Methods: This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 guidelines and the Cochrane Handbook. Searches were performed in English-language databases (PubMed, Scopus, Web of Science) and Persian-language databases (Magiran, Noormags, SID, and Google Scholar) from inception until January 28, 2025. Relevant keywords in both English and Persian Combined exercise, TNF-α, IL-10, and MS were used. The methodological quality of the included studies was assessed using the PEDro scale. The effect of combined exercise training compared to control groups was evaluated using the weighted mean difference (WMD) with a 95% confidence interval (CI), and heterogeneity was assessed using the I² index. Publication bias was examined through funnel plots and Egger’s test. Results: A total of 8 studies, including 256 patients with multiple sclerosis, were included in the meta-analysis. Combined exercise training resulted in a non-significant change in TNF-a [WMD= -0.665 (0.168 to -1.499) P=0.118] and IL-10 [WMD= 0.456 (2.421 to -1.508) P=0.649] It was observed that combined exercise training produced a non-significant change compared to the control group in patients with multiple sclerosis. Conclusion: Combined exercise training in patients with multiple sclerosis resulted in a non-significant change in TNF-α and IL-10 levels compared to the control group. To more accurately assess the effects of these exercises on immune responses, future studies with larger sample sizes and controlled designs are warranted. |
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| Keywords: Combined exercises training, tumor necrosis factor alpha, interleukin 10, multiple sclerosis. |
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Type of Study: Review Article |
Subject:
Sport Physiology
Received: 2025/04/6 | Accepted: 2025/10/4 | Published: 2025/10/19
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