STUDY: Effect of High-Intensity Exercise on Multiple Sclerosis Function

[ActiveMSers]

Medicine & Science in Sports & Exercise. Publish Ahead of Print():, JAN 2019

DOI: 10.1249/MSS.0000000000001914 ,
PMID: 30707115

Issn Print: 0195-9131

Publication Date: 2019/01/30


Effect of High-Intensity Exercise on Multiple Sclerosis Function and 31P MRS Outcomes

Anna Orban; Bharti Garg; Manoj K. Sammi; Dennis N. Bourdette; William D. Rooney; Kerry Kuehl; Rebecca I. Spain

PURPOSE
We determined if a high-intensity aerobic exercise program would be safe, improve expected fitness and clinical outcomes, and alter exploratory phosphorous magnetic resonance spectroscopy (31P MRS) outcomes in persons with multiple sclerosis (PwMS).

METHODS
This open-label prospective pilot study compared 2 cohorts of ambulatory PwMS matched for age, sex and VO2max. Cohorts underwent 8-weeks of high-intensity aerobic exercise (MS-Ex, n=10) or guided stretching (MS-Ctr, n=7). Aerobic exercise consisted of four 30-minute sessions per week while maintaining >70% maximal heart rate. Changes in cardiorespiratory fitness, clinical outcomes, and 31P MRS of tibialis anterior muscle (TA) and brain were compared. Cross-sectional 31P MRS comparisons were made between all MS participants and a separate matched healthy control (HC) population.

RESULTS
The MS-Ex cohort achieved target increases in VO2max (mean +12.7%, p=<0.001, between-group improvement p=0.03). One participant was withdrawn for exercise-induced syncope. The MS-Ex cohort had within-group improvements in fat mass (-5.8%, p=0.04), lean muscle mass (+2.6%, p=0.02), Symbol Digit Modalities Test (+15.1%, p=0.04), and cognitive subscore of the Modified Fatigue Impact Scale (MFIS: -26%, p=0.03) while only the physical subscore of the MFIS improved in MS-Ctr (-16.1%, p=0.007). 31P MRS revealed significant within-group increases in MS-Ex participants in TA rate-constant of PCr recovery (kPCr; +31.5%, p=0.03) and ATP/PCr (+3.2%, p=0.01), and near significant between-group increases in TA kPCr (p=0.05) but no significant changes in brain 31P MRS following exercise. Cross-sectional differences existed between MS and HC brain PCr/Pi (4.61 ± 0.44, 3.93 ± 0.19 p=0.0019).

CONCLUSION
High-intensity aerobic exercise in PwMS improved expected cardiorespiratory and clinical outcomes but provoked one serious adverse event. 31P MRS may serve to explore underlying mechanisms by which aerobic exercise exerts cerebral benefits.

[ActiveMSers]

Note this isn't HIIT. This was 30 minutes of steady exercise at 70% effort. Hard, but not HIIT.

[ActiveMSers]

Article: Aerobic Exercise Helps Multiple Sclerosis—But How and How Fast?

Been meaning to share this. More evidence (on top of more evidence, on top of more evidence...) -D

In our study, as reported in the July 2019 issue of Medicine & Science in Sports & Exercise®, my colleagues and I demonstrated that a high-intensity aerobic exercise program in a mild-to-moderately disabled MS population typically results in rapid cardiovascular improvement and also produced expected benefits of improved V?O2max, peak work, etc. These benefits were achieved despite the subjects’ physical limitations and underlying fatigue. Further, the MS cohort (n=10) also demonstrated significant improvements in cognitive processing speed and reductions in cognitive fatigue compared to a control MS stretching group (n=7). While the exercise training was safe and well-tolerated by the subjects, a re-emergence of exercise-induced syncope served as a reminder that prudence of supervision is essential when initiating a high-intensity exercise program in patients with MS.

FULL ARTICLE:
http://www.multibriefs.com/briefs/acsm/active090319.htm