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Preference and Tolerance of Exercise Intensity in MS

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  • Preference and Tolerance of Exercise Intensity in MS

    Preference and Tolerance of Exercise Intensity in Multiple Sclerosis: Influence on Physiological and Perceptual Outcomes?


    Background: Multiple sclerosis(MS) is an immune-mediated disease of the central nervous system that results in walking dysfunction and physiological deconditioning (i.e., reduced aerobic capacity) that worsens as a result of increasing disability. Exercise training can target the cycle of physiological deconditioning and worsening disability, and may be a primary approach for slowing or reversing disability progression in persons with MS. High-intensity interval exercise (HIIE), in particular, has led to significant improvements in fitness in healthy and clinical populations, including persons with MS. According to the guidelines of the American College of Sports Medicine, information regarding individual preference for and tolerance of exercise intensity should be considered when developing and modifying exercise prescriptions for successful exercise adherence.

    Objectives: To examine the associations of preference for and tolerance of exercise intensity with physiological performance and perceptual outcomes during an incremental, maximal exercise test (IET) and single sessions of HIIE and moderate intensity continuous exercise(MIC) using recumbent arm/leg stepping in persons with MS.

    Methods: Participants with mild-to-moderate MS(N=20) completed the Preference for and Tolerance of the Intensity of Exercise Questionnaire(PRETIE-Q) for measuring Preference(PREF) and Tolerance(TOL) and then underwent the IET on a recumbent arm/leg stepper. This was followed by HIIE and MIC exercise bouts on the same device over the following 2 weeks. The HIIE bout consisted of 10 cycles of 1-min intervals at the wattage associated with 90% VO2peak followed by 1-min recovery intervals at 15W for a total of 20 minutes of exercise. The MIC bout involved 20 minutes of stepping at the wattage associated with 50-60% VO2peak. Oxygen consumption(VO2), power output(PO), and Ratings of Perceived Exertion(RPE) were outcomes measured during the IET, HIIE, and MIC sessions.

    Results: PREF was associated with PO during the IET(r =.59, p=.01), HIIT(r =.54, p =.03), and MIC(r =.61, p=.01) sessions and RPE during the HIIT(r=-.55, p=.02) and MIC(r =-.49, p=.04) sessions. Preferences for higher intensity were thus associated with greater PO and lower RPE. TOL was significantly associated with PO during IET(r=.52, p=.03), HIIT(r=.47, p=.05), and MIC(r =.55, p= .02) sessions. Those with greater tolerance for higher intensity had greater PO across all exercise sessions. Neither PREF or TOL scores were associated with VO2 during the IET, HIIT, or MIC sessions.

    Conclusions: PREF and TOL scores, through associations with PPO and RPE, may be important for personalizing and modifying exercise prescriptions in persons with MS.

    Elizabeth Hubbard
    Berry College
    Steven J Petruzzello
    University of Illinois at Urbana-Champaign
    Rob Motl
    University of Alabama at Birmingham
    Dave Bexfield