Cognition and Measures of Physical Activity,Mobility,and Gait in Individuals With Multiple Sclerosis: A Systematic Review

Abstract

Introduction

Impairments in cognition are prominent for individuals with multiple sclerosis (MS) and have been linked to low levels of physical activity (PA) and walking impairment. However, this relationship remains inconsistent, necessitating the synthesis of current literature to yield collective knowledge.

Objective

To investigate the relationship between cognition and measures of PA, mobility, and gait quality in individuals with MS.

Methods

Relevant, peer-reviewed research articles were identified through a systematic search of MEDLINE, EMBASE, PsycINFO, SPORTSDiscus, and CINAHL from inception to April 2, 2024. Eligible studies explored the relationship between cognition and measures of PA, mobility, and gait quality. The Standard Quality Assessment Criteria for quantitative studies was employed for quality assessment.

Results

Twenty-six studies with a total of 3248 participants were identified in this review, of which 21 studies indicated strong methodological quality. Our review found that processing speed holds a significant relationship with PA volume, but not PA intensity metrics. Mobility and gait quality outcomes were associated with varying cognitive domains, including processing speed, executive function, verbal memory, and visuospatial memory. The magnitudes of the association between cognition and PA, mobility, and gait quality were mostly weak-to-moderate.

Conclusion

Processing speed appears to be collectively associated with PA volume, mobility, and gait quality. However, the evidence supporting this conclusion is largely based on correlational studies involving individuals with mild-to-moderate ambulation disability, warranting future research.