For people with multiple sclerosis (MS), all forms of exercise are likely to be beneficial for physical fitness, but certain forms of exercise may be better than others at improving specific measures of fitness, according to a review of multiple clinical trials. Results suggest that resistance training — pushing or pulling against a force, such as lifting weights to push against gravity — is best for improving muscle fitness, while aerobic exercise (jogging, cycling, and other activities that raise the heart rate) was better for improving heart and lung fitness. "Physical exercise is a beneficial intervention to improve fitness in people with MS," researchers wrote. "Resistance training and aerobic exercise seem to be the types of exercise most effective in improving muscular fitness and [cardiorespiratory fitness], respectively." The study, "Effect of different types of exercise on fitness in people with multiple sclerosis: A network meta-analysis," was published in the Scandinavian Journal of Medicine & Science in Sports. Meta-analysis included data from 72 randomized clinical trials. Getting regular physical exercise has many well-established health benefits, from boosting mood to reducing the risk of heart disease, and it's generally recommended that people with MS take steps to stay physically active. Getting more exercise will generally lead to an increase in overall physical fitness. However, not much research is available on what type(s) of exercise are best suited to improve specific aspects of fitness for people with MS. Here, a group of researchers based in Spain and Chile conducted a meta-analysis of data from the available scientific literature to identify what types of exercise are best for promoting muscle fitness (i.e., muscle strength and endurance) or cardiorespiratory fitness (the body's ability to efficiently utilize oxygen during strenuous exercise). In a meta-analysis, scientists pool data from multiple prior studies and analyze it collectively. The review included data from 72 previous randomized clinical trials, covering 2,543 people living with MS. Patients ranged in age from the early 30s to mid 60s, with disease duration varying from less than two years to more than two decades. Physical exercise interventions were classified into five types: resistance training, aerobic exercise, combined training including both resistance and aerobic exercise simultaneously, sensorimotor training that aims to improve coordination and balance, and mind-body exercises like yoga and Pilates. Results showed that, regardless of the type of exercise, people with MS who participated in exercise programs generally tended to report improvements in measures of fitness, and those who exercised more tended to report bigger improvements. Aerobic exercise and resistance training deemed 'most effective' However, some types of exercise appeared to have a stronger effect than others. Specifically, data suggested that aerobic exercise and combined exercise programs tended to yield the biggest benefit in terms of cardiorespiratory fitness, whereas resistance or combined training had the biggest effect on muscle fitness. "Our results indicate that resistance and combined training for muscular fitness and aerobic exercise for [cardiorespiratory fitness] are the most effective exercise modalities," the researchers wrote. Based on the findings, the team suggested that "healthcare professionals should consider resistance training and aerobic exercise when encouraging people with MS to improve muscular fitness and [cardiorespiratory fitness], respectively." When the researchers attempted to do subgroup analyses based on MS severity, they found consistent effects among people with relatively mild disease. However, because there were far fewer people with severe MS included in the studies, it was not possible to reliably calculate the effect in patients with severe disease.