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At first blush this result is disappointing. But the full study is available to read, and it uncovers some issues. Two stand out, although others are noted.
First, the disability level of participants is low, and cognition issues are low as well, something the authors acknowledged.
Second, and critical IMO, was the intensity level. Note this is interval training, not high-intensity interval training. Past studies have shown light to moderate aerobic exercise in MSers, while good for overall health, has little effect on cognition (or fatigue).
What to make of all of this? I dunno. It seems like a well-done study, but it's a shoulder shrugger. It answered little. Meh. - D
Short-term interval aerobic exercise training does not improve memory functioning in relapsing-remitting multiple sclerosis—a randomized controlled trial
Research article
Clinical Trials Immunology Neurology Psychiatry and Psychology
Lisa Baquet, Helge Hasselmann, Stefan Patra, et al.
Published December 12, 2018
PubMed 30581662
Abstract
Background
Only few aerobic exercise intervention trials specifically targeting cognitive functioning have been performed in multiple sclerosis.
Objective and Methods
This randomized controlled trial with 34 patients in the intervention group (IG) (mean: 38.2 years (±9.6)) and 34 patients in the control group (CG) (mean: 39.6 years (±9.7)) aimed to determine the effects of aerobic exercise on cognition in relapsing-remitting multiple sclerosis (RRMS). The primary outcome was verbal learning assessed by the verbal learning and memory test (VLMT). Patients were randomized to an IG or a waitlist CG. Patients in the IG exercised according to an individually tailored training schedule (with two to three sessions per week for 12 weeks). The primary analysis was carried out using the intention-to-treat (ITT) sample with ANCOVA adjusting for baseline scores.
Results
A total of 77 patients with RRMS were screened and 68 participants randomized (CG n = 34; IG n = 34). The sample comprised 68% females, had a mean age of 39 years, a mean disease duration of 6.3 years, and a mean expanded disability status scale of 1.8. No significant effects were detected in the ITT analysis for the primary endpoint VLMT or any other cognitive measures. Moreover, no significant treatment effects were observed for quality of life, fatigue, or depressive symptoms.
Conclusion
This study failed to demonstrate beneficial effects of aerobic exercise on cognition in RRMS. The trial was prospectively registered at clinicaltrials.gov (NCT02005237).
FULL ARTICLE:
https://peerj.com/articles/6037/
First, the disability level of participants is low, and cognition issues are low as well, something the authors acknowledged.
Compared to our previous study in progressive MS patients (Briken et al., 2014), RRMS patients in the current trial were substantially less disabled physically and cognitively when entering the trial, thereby potentially limiting room for improvements (ceiling effect). Mean EDSS values were below 2.0 which were the lowest among 26 recently reviewed exercise interventions in MS assessing cognition as an outcome (Sandroff et al., 2016). In addition, all mean baseline scores on cognitive function were within one SD of normative values. In contrast, at least 40% of unselected RRMS cohorts show cognitive deficits (Chiaravalloti & DeLuca, 2008)
Training intensity—albeit carefully tailored to the individual patient’s level of fitness at baseline—was only moderate and training frequency deliberately set at the lower end. Certainly, the low intensity may account for the negative findings.
Short-term interval aerobic exercise training does not improve memory functioning in relapsing-remitting multiple sclerosis—a randomized controlled trial
Research article
Clinical Trials Immunology Neurology Psychiatry and Psychology
Lisa Baquet, Helge Hasselmann, Stefan Patra, et al.
Published December 12, 2018
PubMed 30581662
Abstract
Background
Only few aerobic exercise intervention trials specifically targeting cognitive functioning have been performed in multiple sclerosis.
Objective and Methods
This randomized controlled trial with 34 patients in the intervention group (IG) (mean: 38.2 years (±9.6)) and 34 patients in the control group (CG) (mean: 39.6 years (±9.7)) aimed to determine the effects of aerobic exercise on cognition in relapsing-remitting multiple sclerosis (RRMS). The primary outcome was verbal learning assessed by the verbal learning and memory test (VLMT). Patients were randomized to an IG or a waitlist CG. Patients in the IG exercised according to an individually tailored training schedule (with two to three sessions per week for 12 weeks). The primary analysis was carried out using the intention-to-treat (ITT) sample with ANCOVA adjusting for baseline scores.
Results
A total of 77 patients with RRMS were screened and 68 participants randomized (CG n = 34; IG n = 34). The sample comprised 68% females, had a mean age of 39 years, a mean disease duration of 6.3 years, and a mean expanded disability status scale of 1.8. No significant effects were detected in the ITT analysis for the primary endpoint VLMT or any other cognitive measures. Moreover, no significant treatment effects were observed for quality of life, fatigue, or depressive symptoms.
Conclusion
This study failed to demonstrate beneficial effects of aerobic exercise on cognition in RRMS. The trial was prospectively registered at clinicaltrials.gov (NCT02005237).
FULL ARTICLE:
https://peerj.com/articles/6037/
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