Structured exercise is associated with improved functional outcomes in myopathies and related neuromuscular diseases: a systematic review and exploratory dose-response meta-analysis
Abstract
BackgroundEvidence on exercise for myopathies and related neuromuscular diseases is limited by small trials, heterogeneous outcomes and multiple correlated effects from the same trial. We reassessed the evidence using an independent-trial primary analysis and a multilevel supportive analysis. Methods: we searched Web of Science, Cochrane Library, SPORTDiscus, Embase and PubMed from inception through 5 October 2026. Hedges' g was calculated from auditable between-group summaries, with positive values favoring exercise. The primary random-effects model included one functional effect per independent trial and used Knapp-Hartung inference. A multilevel REML model included all valid effects nested within trial. Planned weekly exercise volume was calculated as session duration × frequency (min/week) and examined in linear meta-regression; intensity was not weighted. Results: twenty-two reports representing 21 independent studies and 614 participants across the reported study cohorts were included in the systematic review. The corrected quantitative data set comprised 21 valid effects from 13 independent trials; 403 participants contributed data to the primary analysis. The primary analysis found a positive pooled effect (g = 0.567, 95% CI 0.268 to 0.867; p = 0.001; I2 = 44.8%), although the 95% prediction interval crossed zero (−0.243 to 1.377). The supportive multilevel estimate was g = 0.511 (95% CI 0.258 to 0.764; p < 0.001). Disease-category moderation was not significant (p = 0.518); outcome-domain findings were restricted to descriptive summaries because several domains contained one trial. The primary linear dose slope was 0.019 in Hedges' g per 100 min/week (95% CI −1.699 to 1.736; p = 0.980). All 13 leave-one-trial-out confidence intervals remained above zero. Conclusions: Low-certainty evidence suggests a positive average functional effect of structured exercise, but the prediction interval, heterogeneous outcomes and sparse subgroups limit certainty. No linear dose-response association was detected, and the findings do not establish an individual exercise prescription threshold.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251230000, CRD420251230000.
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BibTeX
@article{chen2026structured,
title = {{Structured exercise is associated with improved functional outcomes in myopathies and related neuromuscular diseases: a systematic review and exploratory dose-response meta-analysis}},
author = {Xinglong Chen and Quanhong Lu and Deke Liu and Yunmei Chai},
journal = {Frontiers in Public Health},
year = {2026},
month = nov,
doi = {10.3389/fpubh.2026.1997358},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1997358},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Structured exercise is associated with improved functional outcomes in myopathies and related neuromuscular diseases: a systematic review and exploratory dose-response meta-analysis
AU - Xinglong Chen
AU - Quanhong Lu
AU - Deke Liu
AU - Yunmei Chai
PY - 2026
DA - 2026/11/09
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1997358
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1997358
AB - BackgroundEvidence on exercise for myopathies and related neuromuscular diseases is limited by small trials, heterogeneous outcomes and multiple correlated effects from the same trial. We reassessed the evidence using an independent-trial primary analysis and a multilevel supportive analysis. Methods: we searched Web of Science, Cochrane Library, SPORTDiscus, Embase and PubMed from inception through 5 October 2026. Hedges' g was calculated from auditable between-group summaries, with positive values favoring exercise. The primary random-effects model included one functional effect per independent trial and used Knapp-Hartung inference. A multilevel REML model included all valid effects nested within trial. Planned weekly exercise volume was calculated as session duration × frequency (min/week) and examined in linear meta-regression; intensity was not weighted. Results: twenty-two reports representing 21 independent studies and 614 participants across the reported study cohorts were included in the systematic review. The corrected quantitative data set comprised 21 valid effects from 13 independent trials; 403 participants contributed data to the primary analysis. The primary analysis found a positive pooled effect (g = 0.567, 95% CI 0.268 to 0.867; p = 0.001; I2 = 44.8%), although the 95% prediction interval crossed zero (−0.243 to 1.377). The supportive multilevel estimate was g = 0.511 (95% CI 0.258 to 0.764; p < 0.001). Disease-category moderation was not significant (p = 0.518); outcome-domain findings were restricted to descriptive summaries because several domains contained one trial. The primary linear dose slope was 0.019 in Hedges' g per 100 min/week (95% CI −1.699 to 1.736; p = 0.980). All 13 leave-one-trial-out confidence intervals remained above zero. Conclusions: Low-certainty evidence suggests a positive average functional effect of structured exercise, but the prediction interval, heterogeneous outcomes and sparse subgroups limit certainty. No linear dose-response association was detected, and the findings do not establish an individual exercise prescription threshold.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251230000, CRD420251230000.
SN - 2296-2565
ER -