What's the single best exercise? Whoa.

[ActiveMSers]

"What’s the Single Best Exercise?" was a topic in a recent NYT Magazine. While it is not multiple sclerosis specific, the article highlighted some really cool science and reinforces my recommendation for MSers to work out in bursts. The technique may be more effective than even I thought possible.

"High-intensity interval training, or H.I.T. as it’s familiarly known among physiologists, is essentially all-interval exercise. As studied in Gibala’s lab, it involves grunting through a series of short, strenuous intervals on specialized stationary bicycles, known as Wingate ergometers. In his first experiments, riders completed 30 seconds of cycling at the highest intensity the riders could stand. After resting for four minutes, the volunteers repeated the interval several times, for a total of two to three minutes of extremely intense exercise. After two weeks, the H.I.T. riders, with less than 20 minutes of hard effort behind them, had increased their aerobic capacity as much as riders who had pedaled leisurely for more than 10 hours."

A modified version of this is a 60 second sprint at a doable pace followed by a 60-second spin. This is done for 20 minutes. Even runners who add sprints to their workouts see big gains.

I've started to add more high-intensity interval training to my workouts on the bike, but for it to work, it has to HURT (especially if you are doing 30 second bursts). And that makes it hella hard, even if the overall workout time is short. And you better have a strong heart--beginners do NOT try.

The full article, which is fascinating, is available here (you may need to pay):
http://www.nytimes.com/2011/04/17/ma...1&ref=magazine

[AMFADVENTURES]

That article is exactly right, H.I.T.'s are the way to big gains in cardiovascular fitness. But, don't try it without building a good base for several months first. They didn't stress that enough!

[ActiveMSers]

AHA. I've found that HIT was just tested in multiple sclerosis, with a study released in February. The HIT group appeared to perform slightly better, but all improved mobility. - Dave

Exercise for multiple sclerosis: a single-blind randomized trial comparing three exercise intensities

Abstract

Background: The most effective exercise dose has yet to be established for multiple sclerosis (MS).

Objective: The aim of this study was to investigate the effect of different exercise intensities in people with MS.

Methods: We completed a randomized comparator study of three cycling exercise intensities, with blinded assessment, was carried out in Oxford. Sixty-one adults with MS who fulfilled inclusion criteria were randomized at entry into the study, using a computer-generated list held by an exercise professional, into either: continuous (at 45% peak power, n = 20), intermittent (30 sec on, 30 sec off at 90% peak power, n = 21) or combined (10 min intermittent at 90% peak power then 10 min continuous at 45% peak power, n = 20) exercise for 20 min twice a week for 12 weeks in a leisure facility. Groups were assessed at: baseline, halfway (6 weeks), end intervention (12 weeks) and follow-up (24 weeks). Primary outcome measure was 2 min walk.

Results: Fifty-five participants were included in the analysis (n = continuous 20, intermittent 18, combined 17). No differences were found between groups. After 6 weeks, considering all participants, 2 min walk distance increased by 6.96 ± 2.56 m (95% CI: 1.81 to 12.10, effect size (es): 0.25, p < 0.01). The continuous group increased by 4.71 ± 4.24 m (95% CI: −3.80 to 13.22, es: 0.06), intermittent by 12.94 ± 4.71 m (95% CI: 3.97 to 21.92, es: 0.28) and combined by 3.22 ± 4.60 m (95% CI: −6.01 to 12.46, es: 0.04). Two minute walk did not significantly change between further assessments. Between 6 and 12 weeks there was a drop in attendance that seemed to be associated with the intermittent and combined groups; these groups also had a greater number of adverse events (leg pain during cycling most common) and dropouts (n = continuous 1, intermittent 5, combined 10). Considering all participants, 6 weeks of cycling exercise produced benefits in mobility that were maintained with further sessions.

Conclusion: While no differences were found between groups, greater benefit may be associated with higher-intensity exercise, but this may be less well tolerated.

[ActiveMSers]

It interesting to note in the above MS study that the primary outcome was measured in a 2-minute walk, IMO a mediocre way to gauge the success of an exercise routine—especially in terms of aerobic fitness.

At home when I work on my bike (which works arms & legs), my absolute peak speed is 18.5 mph, maybe 19, which I can do for 30 seconds max. A good pace for me is 13-14 mph, which is doable for 5-10 minutes. My loungy pace: 11-12 mph, and restful spinning at 10 mph. A 45% rate of peak would be only 8-9 mph, which would not get my HR much above 100 bpm, especially if it were my entire workout.

[AMFADVENTURES]

6/6/2011
Dave,
Yeah, that study was sort of designed for success. Sports physiology literature is filled with stuff on the benefits of HIT training. A more interesting study would include a rigourous evaluation again at 1, 3 and 5 years. I'd venture you'd see some truly incredible results there and you might start to get a feel for the effects on MS progression, nervous system re-networking and even regeneration and a whole host of other impaired immune system responses.

HIT training is a great way to build strength and endurance but it has to be done correctly! One or two times per week is all you need, more can actually damage your endocrine system. And it should be supplemented with exercise at a lower heart rate on other days. So far, I've not seen anything indicating that the effects of high intensity exercise would be any different for a MSer, temporary symptom worsening aside. If you can handle the temporary symptom problems, go for it. In my experience, even some of the temporary symptom situation improved over a period of years.

Dave, for you, a heart rate of 100+ BPM (10 - 12 MPH) in a session the day AFTER a HIT session might be perfect. That's a recovery session and should actually help to solidify the benefits of the HIT. Your case would be particularly interesting since you lost so much of your nervous system to the MS prior to the HALT proceedure. Seems like any improvements you made would have to be neural regeneration or re-networking. Both of those are very slow processes, it will take great deal of patience and perseverance but sure would be interesting to see how far you can get.