STUDY: Does aerobic training alleviate fatigue, improve societal participation in MS?

[ActiveMSers]

Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial

Martin Heine, Olaf Verschuren, Erwin LJ Hoogervorst, ...
First Published May 22, 2017 Research Article

Abstract

Background:
Evidence supporting the effectiveness of aerobic training, specific for fatigue, in severely fatigued patients with multiple sclerosis (MS) is lacking.

Objective:
To estimate the effectiveness of aerobic training on MS-related fatigue and societal participation in ambulant patients with severe MS-related fatigue.

Methods:
Patients (N = 90) with severe MS-related fatigue were allocated to 16-week aerobic training or control intervention. Primary outcomes were perceived fatigue (Checklist Individual Strength (CIS20r) fatigue subscale) and societal participation. An improvement of ⩾8 points on the CIS20r fatigue subscale was considered clinically relevant. Outcomes were assessed by a blinded observer at baseline, 2, 4, 6 and 12 months.

Results:
Of the 89 patients that started treatment (median Expanded Disability Status Scale (interquartile range), 3.0 (2.0–3.6); mean CIS20r fatigue subscale (standard deviation (SD)), 42.6 (8.0)), 43 received aerobic training and 46 received the control intervention. A significant post-intervention between-group mean difference (MD) on the CIS20r fatigue subscale of 4.708 (95% confidence interval (CI) = 1.003–8.412; p = 0.014) points was found in favour of aerobic training that, however, was not sustained during follow-up. No effect was found on societal participation.

Conclusion:
Aerobic training in MS patients with severe fatigue does not lead to a clinically meaningful reduction in fatigue or societal participation when compared to a low-intensity control intervention.

FULL ARTICLE:
http://journals.sagepub.com/doi/pdf/...52458517696596

[ActiveMSers]

With the full article available online, we can take a closer look at the results, and they are illuminating. For starters, the exercise tested was aerobic interval training, and participants in the test group averaged 14 (between somewhat hard and hard) on the Borg excursion scale (6-20). This is decent intensity, but not high. For HIIT, high intensity interval training, intensity should be significantly higher, in the 17-19 range (very hard to extremely hard).

Also note, that after the 12 supervised visits, the remaining 36 sessions were done at home. It's no surprise that there was a significant difference in fatigue at week 16 to the control group (the last supervised visit), but the difference between the two groups gradually evaporated as the year wore on. Were participants exercising as hard and with purpose at home as they had in the lab? The dropout rate increased as well.

These results highlight what recent research has reinforced. Moderate aerobic exercise, while good for your health, does not appear to have a significant effect on fatigue. And if intense aerobic exercise is not regularly maintained, fatigue gains will vanish. - D