QUESTION: Physical activity (PA) is recommended for people with central neurological conditions PA recommendations differed between studies, regardless of the central neurological condition studied. This systematic review of the literature allows the synthesis of PA recommendations with the aim of defining which PA to perform, for which dosage and which effects for MS, PD, SCI and stroke. METHOD: This literature review queries 3 databases over 20 years (from 01/01/2000 to 31/12/2020), given the small number of studies published on the subject. For each neurological pathology encountered in adults (stroke, MS, PD, SCI) the frequency, intensity, type and effects of PA will be extracted. Articles studying PA combined with another treatment or intervention other than PA were excluded. For each included article, the methodological quality was assessed. RESULTS: Of 2,539 identified references, 25 articles were included. Two articles had an evidence level of 1, 16 had an evidence level of 2, and 7 had an evidence level of 4. Strength training, endurance, stretching, and balance were recommended for all 4 conditions. PA had few adverse effects except for stroke, where it is more likely to trigger cardiovascular disorders inherent to the disease. CONCLUSION: Resistance training with an intensity at 60 +/- 20% of 1RM, with 3 series of 11 +/- 3 repetitions, and performed 2 to 3 time a week enhances the strength of stroke, MS, PD, and SCI. Endurance training with an intensity of 50 +/- 10% of Heart Rate Reserve (HRR), for a duration of 30 to 60 min per session and performed 3 to 7 time a week decreases cardiovascular disorders and enhances mobility for stroke, MS, PD, and SCI. Daily stretching, maintained 30 to 60 s per muscles for MS and SCI, and maintained 10 to 30 s for PD and stroke enhances flexibility, range of motion and posture. PA training balance (Tai-Chi, yoga, dance, etc) performed 2 to 3 time a week enhances daily life activity for MS, stroke and PD. PA guidelines for neurological disorder were defined thanks to PA guidelines for healthy people, but dosage and exercises were adapted for each neurological disorders. As few articles were found for PD, guidelines have to be improved. MS, stroke and SCI PA guidelines are of better quality than PD but should be improved because of the low number of articles found for this review.

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