| Study characteristics | Participant characteristics | Exercise training characteristics | Outcomes |
| Ref. (quality) | n | Exercise modality | Gender (% F) | EDSS | Disease duration(y) mean ± SD | | Duration (weeks) | Frequency (x/week) | Time (min/session) | Intensity | Outcomes postintervention | Robot-Assisted Gait Training (RAGT) (17 studies) | | Androwis, G. et al. [45] | 6 | RAGT | 50% | Ambulation index ≥2 | NR | | 4 weeks | 2/week | 45 min | Gradually ↓ BWS | ↑ cognitive function, ↑ thalamocortical resting-state functional connectivity, ↓ TUG | Berriozabalgoitiaet al., [46] | 18 | RAGT+gait training Ex. | 50% | 4.5-7.0 | 12.94_8.11 | | 3 months | 2/week | 40 min | Gradually ↑ time and ↓ BWS | ↓ 10WMT, ↑ balance, ↓ fatigue, ↓ TUG | Druzbicki, M et al. [47] | 14 | RAGT | 57% | 5-6 | NR | | 3 weeks | 5/week | 45-60 min | Gradually ↓ BWS | ↔ balance, ↓ fatigue, ↓ T25-FW | Sconza, C.,et al. [48] | 10 | RAGT+general Ex. (cross-over design) | 84.2% | 3.5-7 | NR | (36-74) | 5 weeks | 5/week | 90 min | 40% BWS treadmill speed of 1.5 km (↓ gradually) | ↑ 6MWT, ↓ EDSS, ↓ T25FW, SLR, ↓ spasticity | Afzal et al. [36] | 10 | RAGT | 80% | 6.0-7.5 | | | 3 weeks | 5/week | 90 min | Gradually ↑ intensity | ↔ 6MWT, ↑ T25FW-self-selected, ↔ T25FW-fast speed, ↓ NVO2 peak, ↔ TUG | Berchicci et al. [37] | 5 | RAGT | 40% | 5.0-7.0 | NR | | 6 weeks | 2x/5/week | 45 min | NR | ↑ T25FW, ↑ 2MWT, ↑ Tinetti test, ↑ BBS, ↓ fatigue , ↑ FSS, ↑ EBI, ↓ EDSS | Daniele Munaria et al. [42] | 8 | RAGT-VR | 62.50% | 3.0-6.0 | | | 6 weeks | 2/week | 40 min | Gradually ↓ BWS | , | Manfredini et al. [41] | 23 | RAGT | 67% | 6.0-7.0 | | | 6 weeks | 2/week | 40 min | Gradually ↑ (distance, speed), ↓ guidance force | ↑ 6MWT, improve mitochondrial function biomarker, ↑ rmVO2 | Straudi et al. [43] | 36 | RAGT | 67% | 6.0-7.0 | 12 (6-9) | | 4 weeks | 3/week | 120 min | Gradually ↑ (distance, speed), ↓ guidance force | ↓ T25FW, ↑ 6MWT ↓ TUG, ↑ PHQ-9, ↓ FSS, ↑balance, ↑ QoL, ↑ mental health | McGibbon et al. [34] | 35 | Home lower exoskeleton (Keeogo) (cross-over design) | 58.60% | 4-6.5 | NR | | 6 weeks | 4 weeks at home (2 weeks with Keeogo, 2 weeks without Keeogo) | All the day | NR | , , ; post 2 weeks with Keeogo at home ⟶ ↑ unassisted 6MWT distance, ↑ unassisted stair climbing performance | Pompa et al. [31] | 25 | RAGT | 47.60% | 6.0–7.5 | | | 4 weeks | 3/week | 40 | 40-50% BWS (↓ gradually) | , , , , , , | Straudi et al. [29] | 30 | RAGT | 62.90% | 6.0-7.0 | | | 6 weeks | 2/week | 60 min (30: walking) | 100% guidance +50% BWS (↓ gradually) | | Straudi et al. [24] | 9 | RAGT | 50% | 4.5–6.5 | | | 6 weeks | 2/week | 60 min (30 min/walking) | Gradually (↑ distance, speed), (↓ guidance force) | Improvements in spatiotemporal parameters (, , , ), | Claude Vaney et al. [23] | 26 | RAGT | NR | 3.0-6.5 | NR | 58.23 (9.42) | 3 weeks | 3/week | (30 min/walking) | 50% BWS (↓gradually), ↑speed to normal gait speed | ↑ QoL, ↑ 3-minute walking speed, , , , , , , | Schwartz et al. [22] | 15 | RAGT | 57% | 5.5–7 | | | 4 weeks | 2-3/week | 45 min (30 min/walking) | 40% BWS (↓ gradually) | | Beer et al. [14] | 19 | RAGT | 63.20% | 6.0–7.5 | | | 3 weeks | 5/week | 30 min | 40–80% BWS, gradually ↑ (distance, speed), ↓ BWS | , , , | Lo et al. [15] | 13 | RAGT+BWST (cross-over design) | 48% F | 3.0 -7.0 | NR | | 6 weeks (3 weeks/phase) | 2/week | 40 min | 30%-40% BWS (↓ gradually), ↑ speed | , , , , | Body weight-supported treadmill training (BWSTT) (5 studies) | | Devasahayam et al. [39] | 10 | BWSTT+ cooling room (16°C) | 90% | 6.0-7.0 (sensitive to heat) | | | 10 weeks | 3/week | 40 min | Gradually increased to vigorous intensity (40–65% HRR) | , , , , , , , , , | Willingham et al. [35] | 6 | BWSTT+ antigravity treadmill training | 50% | 6.0-6.5 | NR | | 8 weeks | 2/week | 20 min | 35%-70% BWS, speed of 8.0 | , | Jonsdottir et al. [32] | 26 | BWSTT if needed+dual task training | 44.70% | 3.5–7 | | | 4 weeks | 5/week | 30 min | –16 RPE | | Pilutti et al. [20] | 6 | BWSTT | 66% | 5.5–8.0 | | | 12 weeks | 3/week | 30 min | Gradually ↑ speed, ↓ BWS | ↓ T25-FW, ↓ fatigue, ↑ QoL, ↓ EDSS | Giesser et al. [13] | 4 | BWSTT | 75% | 7.0-8.0 | | | 20 weeks | 2/week | 60 min | 100% BWS (↓ gradually), ↑ speed to normal gait speed | ↓ 10WMT, ↑ 6MWT, ↑ balance, ↑ QoL, ↓ spasticity, ↑ muscle strength (not all patients were able to complete the 10WMT, 6MWT) | Total-body recumbent stepper training (TBRST) (1 study) | | Pilutti et al. [28] | 5 | TBRST | 40% | 6.0-8.0 | | 58.8 (3.0) | 12 weeks | 3/week | 30 min | Gradually ↑ according to participant ability | ↓ fatigue, ↑ QoL, ↔ T25FW | Home-based exercise (2 studies) | | de Bolt et al. [12] | 19 | Home based resistance Ex. | 78.95% | 1.0 – 6.5. | | | 8 weeks | 3/week | 50 min | Resistance by 0.5% of body weight, ↑ (.05%–1.5%) every 2 weeks | ↓ TUG, ↑ leg extensor power, ↑balance, | Miller et al. [19] | 15 | Home Ex. of task-specific programme | 73.30% | 6.5–8 | | | 8 weeks | 2/week | 60 min | NR | ↑ MSIS-29, ↓ 10WMT, ↑ muscle strength, ↓ timed sit-stand, ↓ EDSS, ↓ FIM | Electrical stimulation (2 studies) | | JE Esnouf et al. [17] | 32 | FES (ODFS) | 61.50% | 4.0-6.5 | 12.5 | 53 | 18 weeks | Daily mobility | All the day | NR | ↓ effort for walking, ↓ tripping, ↑ confidence while walking, ↑ walking distance | CL Barrett et al. [16] | 25 | FES (ODFS) | 75% | 4.0-6.5 | | | 18 weeks | Daily mobility | All the day | Gradually to be worn all the day | ↑ walking speed, ↑ walking distance, ↔ physiological cost index | Blood flow-restriction (2 study) | | Chotiyarnwong, C et al. [38] | 39 | Remote ischaemic preconditioning (RIPC) | 44.7% | 1.0-7.0 | | | 1 session | Blood pressure cuff inflated to (30 mm Hg) above resting systolic pressure | Inflation for 5 min followed by deflation for 5 min/3 | NR | , , | Lamberti et al. [40] | 12 | Blood flow restricted slow walking (BFR-W) | 46% | | | | 6 weeks | 2/week | 60 min | ↑ speed by 3 steps/min, BFR stable | , , , , , , | Conventional exercise training (3 studies) | | Resistance training | | | | | | | | | | | S Briken et al. [25] | 12 | Arm Ergometry | 50% | 4.0-6.0 | | | 8-10 weeks | 2-3/week | 15-45 min | Gradually increase | | 12 | Rowing | 36.60% | 4.0-6.0 | | | 8-10 weeks | 2-3/week | 15-45 min | ↔ 6MWT | 12 | Bicycle ergometry | 54.50% | 4.0-6.0 | | | 8-10 weeks | 2-3/week | 15-45 min | | Hayes et al. [18] | 11 | Lower limb resistance ex | 55.50% | 3.5-6.5 | | 48.0 (11.9) | 12 weeks | 3/week | 45-60 min | Gradually increase | ↑ lower limb strength, ↔ TUG, ↔ 10WMT, ↔ 6MWT, ↑ balance, ↔ fatigue | Aerobic exercise | | | | | | | | | | | Jackson et al. [21] | 15 | Kick boxing | 81.80% | 1.0-6.0 | | | 5 weeks | 3/week | | Gradually increased ≤75% HRR or ≤5 RPE | | Exergaming (1 study) | | Robinson et al. [27] | 20 | (Exergaming) Nintendo Wii Fit | 70% | 6.00 | NR | | 4 weeks | 2/week | 40-60 min | ↑ difficulty | ↓ postural sway, ↑ balance, ↑ step length, ↑ stride length, ↓ MSWS-12 | 18 | Balance training | 63% | 6.00 | NR | | 4 weeks | 2/week | 40-60 min | ↑ difficulty | ↓ postural sway, ↑ balance, ↑ step length, ↑ stride length, ↓ MSWS-12 | Assistive device selection, training and education program (ADSTEP) (1 study) | | Martini et al. [33] | 20 | ADSTEP | 14% | (history of fall) | NR | | 6 weeks | 1/week | 40 min | Aid selection, fitting, task-oriented gait training | , , , , , , , , | Community exercise (2 study) | | KL Williams et al. [44] | 26 | Community group exercise | 65.4% | 0-5 disease step rating scale | 12.4(10.2) | 52.7(11.9) | 8 weeks | 2/week | 60 min | ↑intensity | ↑ 6MWT, ↑ 10WMT, ↑ balance | Hogan et al. [26] | 66 | Group physiotherapy | 62.50% | 3–4 on the mobility section of (GNDS) | 18(9) | 57 (10) | 10 weeks | 1/week | 60 min | Increase the set of (12 repetitions) | , , , component, ↓MFIS | 45 | 1:1 physio-therapy | 57% | 13(8) | 52 (11) | 10 weeks | 1/week | 60 min | Increase the set of 12 repetitions | , , , , , | 16 | Yoga | 61.50% | 15(8) | 58 (8) | 10 weeks | 1/week | 60 min | NR | , , , , , | Ankle robotic training (1 study) | | Lee Y et al. [30] | 7 | Ankle robotic training for impaired leg | 83.30% | | | | 6 weeks | 3/week | 45 min | NR | , , , , |
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