Highlights
- •All three clinical guidelines emphasize the importance of physical activity (especially exercise) for persons with MS
- •Guidelines show moderate to high methodological quality
- •Guidelines hold remarkably diverse physical activity-related content
- •Future guideline development should also include details regarding dose-response relationships, risk and harms, prerequisites for starting moderate to vigorous physical activities, exercise vs. lifestyle physical activity for health, and include recommendations surrounding sedentary behavior.
Abstract
Objective
This paper aims to evaluate the quality of clinical guidelines (CGs) for MS and to
critically appraise physical activity-related recommendations.
Data sources
Medical databases (MEDLINE, TRIP), clearinghouses, and guideline developers. An expert
was asked to confirm if the list of CGs was complete.
Study selection
Evidence-based CGs specific to MS with recommendations including aspects of rehabilitation
or physical activity were included.
Data extraction
Two reviewers independently first assessed the methodological quality of the CGs based
on the 23 items of the Appraisal of Guidelines for Research and Evaluation Instrument
version two (AGREE II) and second evaluated the physical activity-related content
quality using an instrument containing 14 items that was used for the development
of the National Recommendations for Physical Activity in Germany.
Data synthesis
For the AGREE II domains and the criteria for content quality, standardized domain
scores were calculated.
Results
Three CGs were included. The average scores for the methodological quality of the
domains were: scope and purpose (91%), stakeholder involvement (81%), rigor of development
(78%), clarity of presentation (93%), applicability (53%), and editorial independence
(83%). The mean scores for physical activity-related content quality did not exceed
56% for any criteria.
Conclusions
Overall, this critical review shows that the methodological quality of CGs were moderate
to good but physical activity-related content quality was heterogeneous and low. Results
emphasize the need for more specific physical activity recommendations that incorporate
multiple aspects of physical activity prescription.
Keywords
Abbreviations:
ANN (American Academy of Neurology), AGREE (appraisal of guidelines for research and evaluation), CG (clinical guideline), CSEP (Canadian society for exercise physiology), MS (multiple sclerosis), NICE (National Institute for Health and Care Excellence), pwMS (persons with multiple sclerosis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 03, 2018
Accepted:
July 20,
2018
Received in revised form:
July 4,
2018
Received:
April 17,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
