STUDY: High-intensity interval training improves aerobic capacity, fatigue in MS

[ActiveMSers]

This is potentially big. Really big. Fatigue has always been the most common of MS symptoms and it's typically a crusher. What does this new research mean? You just might be able to beat it back with high-intensity interval training.

I've been doing HIIT for years, and for the last couple of years I have focused intently on it, regularly getting my heart rate into the 140s in bursts. Is it helping me walk better? No, as this study confirms. But do I have fatigue? Compared to most with MS, no. Virtually none. At first I thought it was a 50/50 combination of the luck of the draw and exercise, but this research says otherwise. Maybe we can create our own luck.

Join me. A link to my recently published article on exercise hacks is on www.ActiveMSers.org along with 100+ exercise tips. Let's do this! - Dave

High-intensity interval ergometer training improves aerobic capacity and fatigue in patients with Multiple Sclerosis

Stephan Schmidt1, Marc Wonneberger2 1Gesundheitszentrum St.Johannes, 2DAA Gesundheit und Soziales, Schule für Physiotherapie Gummersbach

Objective: To determine the effects of short-term high intensity interval training (HIIT) on aerobic fitness and fatigue in patients with multiple sclerosis (MS).

Background: Physical activity has a positive effect on a variety of attendant symptoms associated with MS. Moderate endurance exercise has been preferentially recommended, but the effects of HIIT are largely unknown.

Design/Methods: 40 patients with relapsing-remitting MS and an EDSS of < 3.5 exercised for eight weeks on a bicycle-ergometer three times weekly according to two different protocols (HIIT versus moderate endurance training) in a prospective monocentric, randomized, simple blinded cohort study. Measurements were taken at baseline and after eight weeks of training. Individual aerobic fitness was assessed by steep ramp anaerobic test (SRAT), fatigue by the Fatigue Severity Scale (FSS), depression by the ADS-L questionnaire, a German version of the Center for Epidemiological Studies Depression Scale (CES-D), sleep quality according to the Pittsburgh Sleep Quality Index (PSQI) and ambulation was measured by the Timed 25-Foot Walk Test (T25-FW) .

Results: 29 patients completed the program. FSS decreased significantly after HIIT (p=0.04) but not after moderate training. Moreover, aerobic fitness increased significantly in the HIIT group (p<0.01). No changes with regard to ADS-L, PQSI and T25FW were detected in both subgroups independent of the presence or absence of fatigue.

Conclusions:
HIIT is a promising time-efficient approach in subjects with MS leading to rapid improvement of aerobic fitness and fatigue.

[ActiveMSers]

Just a reminder, before you start on HIIT, talk to your doctor, neurologist, or physical therapist. Or all three. Be smart. - D

[Suebee]

DAVE, I agree! In my personal experience, HITT is the best way for a person with MS endurance and weakness issues to exercise. I wasn't able to link to your posted article directly for some reason so I can't comment on article directly. But for me, I found I can build up an aerobic exercise movement to up to a minute at 80%+ effort and then switch muscle groups and keep going. At one point, I got up to 20 min no breaks other than changing muscle groups! I felt great and strong! Fancy gym equipment that monitors heartbeat and effort level helped me learn what it physically felt like to go 80% and kept time, reminding me to switch muscle groups. But I also do HITT without fancy gym equipment at home and keep time with an app.

If I may, I will point out an interesting fact that no neurologist or PT ever advised or assisted me to do HITT. In fact, the opposite advice is given to me.. "don't over do... moderate level... walking short distances and resting...etc". I wonder if this is the experience of others here??? But I have only made real gains in strength and endurance when I do HITT.

I hope studies like this will increase understanding about the best way for MS patients to exercise to get optimum results and increase their quality of life. I noticed that the abstract of the article you posted described HITT as an "efficient" method. I think the word choice is not completely accurate. My muscles can handle brief spurts of intense exercise but then completely fatigue. By doing HITT, a MS patient with endurance issues is maximizing their short duration of strength when using HITT workouts. Efficient yes, but kinda misses the point that MS patients who want to increase their strength or maintain, aren't looking for efficiency.

MS patients need to overcome obstacles of poor endurance, physical fatigue, and heat. Look at all the awesome MS athletes on this forum; no where did any one post they like an exercise for the prime reason of efficiency. Everyone here gets excited about a workout routine is tolerable, can be completed, and achieve gains...Just sayin' to scientists who are reading this...

[AMFADVENTURES]

First off, Dave's tips on exercise with MS are EXCELLENT, a must read for beginners and a very complete reminder for experienced exercisers. http://www.activemsers.org/exercises...ingwithms.html

Second, I did suffer horrible, mind crushing, debilitating fatigue in the course of my MS. The fatigue was in fact the single greatest reason I sought medical attention and subsequently received my MS diagnosis. Also, it took years, not months, of exercise to resolve, although my exercise program at the time was poorly laid out and sporadic at best.

And third,
Suebee, yes, I have been berated by renowned physical therapists AND cautioned by highly influential MS neurologists to reign in the intensity I exercise with! I can only imagine this is related to liability issues. Hopefully studies like this one and numerous others, will allow these professionals the leeway to recommend more intense exercise programs for their clients. As an aside, when I questioned these same professionals about their opinions, I generally found out they were related to a lack of evidence and safety concerns.

If I may, I will point out an interesting fact that no neurologist or PT ever advised or assisted me to do HITT. In fact, the opposite advice is given to me.. "don't over do... moderate level... walking short distances and resting...etc". I wonder if this is the experience of others here??? But I have only made real gains in strength and endurance when I do HITT.

[geekgirl]

any HIIT programs/tips?

Thanks for posting the results of this study. Can anyone recommend a HIIT program that they've used that they feel good about? or any resources I should check out? It is aerobic, right? So intervals of "as fast as you can go" then "recovery"?

[mpnDec24]

HIIT--recommend exercises, RT sided weakness!

I was using a stationary bike regularly but severe RT leg weakness prevents that now; also have RT arm weakness so use arm ergometer for the RT (no LT arm or it will take over!). Any ideas for high intensity exercises with RT sided weakness? My LT leg and arm were becoming "overdeveloped" with notable atrophy of the RT that's why I stopped using the stationary bike. Thanks!

[AMFADVENTURES]

Well, I can tell you a few things that seem to have worked for me. You can do HIIT'S on anything that gets your heart rate up, I've used inline elliptical machines (might be better right/left control than a bike), a cross eliptical machine (really puts force on each individual leg, like to the point of collapse), and lately I have even gotten on a tread mill. All of these are weight bearing exercises, something PWMS need to maintain bone density, they are probably even better than just using a bike. I think the idea of a rowing machine is great and an arm crank should work too. You can even get some shorter interval HIIT'S in with weight machines.

Before you start HIIT training you should spend at least 6 weeks exercising at a relatively low heart rate, like where you can still talk in complete sentences. This is a critical step, it develops blood supply to the muscles and strengthens the muscles and tendons so you will avoid problems later.

The basic idea of HIIT's is:
-Warm up for 15 to 20 minutes
-Speed things up or increase resistance as much as you can until you're breathing hard enough that you can't get more than a couple of words out, your heart rate will be up significantly.
-If you can, do this for at least 30 seconds, increasing the amount of time as you get stronger.
- Actively rest, that is keep exercising but slow down as much as you need to to bring your heart rate back down and keep it down for at least as long as your interval was(The resting is critical, you want to recover pretty well before you start the next interval or you don't get the full benefit of the HITTs)
-If you're over 50, limit your HITT sessions to two per week, if you're under 50 you might get away with 3 per week, but don't push it and if you exhaust yourself over a period of a couple of weeks, take it easy, if need be, get your exercise by doing something else until you feel you've recovered sufficently to start again.

Try for 3 to 5 sets initially. As you're able, increase the number of sets and /or increase the length of the interval.
Give yourself time to build up, weeks, months, even years! Don't get frustrated, these things are hard but the payoff can be BIG!

Good luck,

[JonathanNes]

Jonathan, in my best muscle building supplements research, 30 seconds is fine. The minimum is 20 seconds or so for benefit. I usually aim for 30 myself on my sprints. Those last 10 are a beast!

I find it really hard to go all out for a minute. Can I do 30 second intervals?

[AMFADVENTURES]

I find it really hard to go all out for a minute. Can I do 30 second intervals?

Numerous studies have indicated that whatever kind of exercise a person with MS can do is more than likely to help them. If you can do HIIT's at all, and HIIT's are a relatively advanced form of very hard exercise, it is likely to slow the impact of the MS, at the very least. I think I would be concerned less with how long or how many than I would be of just doing what I can. Hope that helps?

Larry

[ActiveMSers]

Jonathan, in my research, 30 seconds is fine. The minimum is 20 seconds or so for benefit. I usually aim for 30 myself on my sprints. Those last 10 are a beast!