{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T23:16:47Z","timestamp":1794007007768,"version":"4.8.0"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2019,11,2]],"date-time":"2019-11-02T00:00:00Z","timestamp":1572652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: People with multiple sclerosis (MS) often experience limitations in joint range of motion, which is linked to spasticity and continued inactivity. Low flexibility levels in this population have been linked to postural problems and muscular pain. Therefore, the purpose of this study was to conduct a systematic review and a meta-analysis aimed at identifying the characteristics and methodological quality of investigations studying the effects of exercise interventions on the flexibility levels of people with MS. Materials and Methods: Three electronic databases (MEDLINE\/PubMed, SPORTDiscus and Scopus) were systematically searched up to May 2019 for intervention studies focused on the effects of exercise on the flexibility levels of people with MS. A meta-analysis, including randomized controlled trials (RCT), which reported information regarding the effects of exercise on flexibility, was also conducted. The methodological quality of included studies was assessed using the Physiotherapy Evidence Database, and the Quality Assessment Tool for Before\u2013After Studies, with no control group. The quality of the information reported, regarding the programs conducted, was assessed by means of the Consensus on Exercise Reporting Template (CERT) scale. Results: Seven studies, four RCTs and three uncontrolled investigations were finally selected. The methodological quality of the RCTs was considered \u201cpoor\u201d in one study, and \u201cgood\u201d and \u201cexcellent\u201d in two studies and one investigation, respectively. The three uncontrolled studies showed a methodological quality between \u201cfair\u201d and \u201cpoor\u201d. Following the CERT scale, four studies were graded as \u201chigh\u201d and three as \u201clow\u201d. Findings from the meta-analysis indicated no significant effects on hamstring flexibility, or the range of motion in the hips, knees or ankles. Conclusions: There is preliminary evidence from individual studies which indicates that people with MS can improve their lower limb flexibility following participation in physical exercise programs, but the meta-analysis did not confirm these findings.<\/jats:p>","DOI":"10.3390\/medicina55110726","type":"journal-article","created":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T04:13:08Z","timestamp":1572840788000},"page":"726","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Exercise Interventions for Improving Flexibility in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3403-7672","authenticated-orcid":false,"given":"Marta","family":"Torres-Pareja","sequence":"first","affiliation":[{"name":"Research Group DEPORSALUD (Physical Activity and Health, Studies in Sports Performance, Disability and Gender), Faculty of Sports Sciences, University of Castilla La-Mancha, A Carlos III s\/n, E-45071 Toledo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7457-3475","authenticated-orcid":false,"given":"Miguel A.","family":"S\u00e1nchez-Lastra","sequence":"additional","affiliation":[{"name":"HealthyFit Research Group, Department of Special Didactics, Faculty of Educational Sciences and Sports, University of Vigo, Campus A Xunqueira s\/n, E-36005 Pontevedra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5178-4974","authenticated-orcid":false,"given":"Laura","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Faculty of Education and Sport Science, University of Vigo, E-36005 Pontevedra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2534-3790","authenticated-orcid":false,"given":"David","family":"Su\u00e1rez-Iglesias","sequence":"additional","affiliation":[{"name":"VALFIS Research Group, Institute of Biomedicine (IBIOMED), Faculty of Physical Activity and Sports Sciences, University of Le\u00f3n, 24071 Le\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6271-3725","authenticated-orcid":false,"given":"Nuria","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria. Ctra Pozuelo a Majadahonda 11-515 KM 1.800, 28223 Pozuelo de Alarc\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3374-843X","authenticated-orcid":false,"given":"Carlos","family":"Ay\u00e1n","sequence":"additional","affiliation":[{"name":"Well-Move Research Group, Department of Special Didactics, Faculty of Educational Sciences and Sports, University of Vigo, Campus A Xunqueira s\/n, E-36005 Pontevedra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,11,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1016\/S0140-6736(18)30481-1","article-title":"Multiple sclerosis","volume":"391","author":"Thompson","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1212\/WNL.0000000000000768","article-title":"Atlas of Multiple Sclerosis 2013: A growing global problem with widespread inequity","volume":"83","author":"Browne","year":"2014","journal-title":"Neurology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/S1474-4422(06)70581-6","article-title":"Sex ratio of multiple sclerosis in Canada: A longitudinal study","volume":"5","author":"Orton","year":"2006","journal-title":"Lancet Neurol."},{"key":"ref_4","first-page":"604","article-title":"Multiple Sclerosis: Progress, but No Cure","volume":"40","author":"Gohil","year":"2015","journal-title":"Pharm. 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