Physical activity aids females with multiple sclerosis but optimal type unclear.

16 studies (579 people) analyzed via seven databases to assess six exercises.

Yoga ranks highest in improving mental health in females with multiple sclerosis.

Exercise improves physical-mental health for females’ multiple sclerosis recovery.

As a therapeutic approach, physical activity can serve as a rehabilitation method for females with multiple sclerosis. However, the optimal exercise type remains unclear. This study aims to evaluate the effects of six distinct training programs on the physical function and psychological state of females with multiple sclerosis, thereby providing foundational guidance for rehabilitation treatment in this population.

In September 2025, a comprehensive literature search was conducted across seven major databases (Embase, PubMed, Web of Science, Cochrane Library, Wanfang, CNKI, and CQVIP) to identify randomized controlled trials to study how physical activity interventions affect the physical function and psychological status in females with multiple sclerosis. These studies were subsequently analyzed through a frequency-based network meta-analysis framework.

We conducted a systematic review analyzing 16 studies involving 579 participants. Among the six exercise modalities tested in the intervention groups, all demonstrated statistically significant efficacy compared to the control groups. However, pairwise comparisons between different exercise categories revealed minimal differences. Using the surface under the cumulative ranking curve (SUCRA) metric, researchers evaluated and ranked the impact of these interventions on both physical function and psychological status in females multiple sclerosis, FATIGUE: Yoga (SUCRA=81) > RE (SUCRA=77) > AE (SUCRA=67.6) > CE (SUCRA=56.0) > CT (SUCRA=30.8) > MBE (SUCRA=25.7) > RT(SUCRA=11.9); QoL-total: RE (SUCRA=69.7) > AE (SUCRA=63.5) > Yoga (SUCRA=63.0) > RT (SUCRA=3.9); BALANCE: AE (SUCRA=89.7) > Yoga (SUCRA=66.9) > MBE (SUCRA=55.0) > RE (SUCRA=36.7) > RT (SUCRA=1.7); Qol-ph: MBE(SUCRA=82.0) > Yoga (SUCRA=78.7) > AE (SUCRA=45.1) > CE (SUCRA=35.8) > RT (SUCRA= 8.5); DEPRESS: Yoga (SUCRA=74.6) > AE (SUCRA=66.3) > CT (SUCRA=53.0) > CE (SUCRA=49.9) > MBE (SUCRA=45.6) > RT (SUCRA=10.6), Qol-mh: Yoga (SUCRA=79.5) > MBE (SUCRA=68.5) > CE (SUCRA=53.9) > AE (SUCRA=46.4) > RT (SUCRA=1.8).

For females with multiple sclerosis, regular physical activity boosts physical function and psychological status outcomes. Among these activities, yoga is the most effective way to improve their psychological well-being.

Exercise

Physical function

Psychological status

Female

Multiple sclerosis

© 2026 The Authors. Published by Elsevier B.V.