Impact of aerobic training on fitness and quality of life in multiple sclerosis

Fifty-four multiple sclerosis (MS) patients were randomly assigned to exercise (EX) or nonexercise (NEX) groups. Before and after 15 weeks of aerobic training, aspects of fitness including maximal aerobic capacity (Vo2max), isometric strength, body composition, and blood lipids were measured. Daily activities, mood, fatigue, and disease status were measured by the Profile of Mood States (POMS), Sickness Impact Profile (SIP), Fatigue Severity Scale (FSS), and neurological examination. Training consisted of 3 × 40-minute sessions per week of combined arm and leg ergometry. Expanded Disability Status Scale (EDSS) scores were unchanged, except for improved bowel and bladder function in the EX group. Compared with baseline, the EX group demonstrated significant increases in Vo2max, upper and lower extremity strength, and significant decreases in skinfolds, triglyceride, and very-low-density lipoprotein (VLDL). For the EX group, POMS depression and anger scores were significantly reduced at weeks 5 and 10, and fatigue was reduced at week 10. The EX group improved significantly on all components of the physical dimension of the SIP and showed significant improvements for social interaction, emotional behavior, home management, total SIP score, and recreation and past times. No changes were observed for EX or NEX groups on the FSS. Exercise training resulted in improved fitness and had a positive impact on factors related to quality of life.     

The positive effects of a physical activity program for multiple sclerosis patients with fatigue

Fatigue is a common and disabling symptom of multiple sclerosis (MS). There is no effective pharmacological treatment for fatigue, although a few reports point towards beneficial effects from physical activity for MS patients suffering from fatigue. We devised a physical activity program for MS patients with fatigue and present the results from our first use of this program, on nine patients from our region. The program consisted of a 20-week series of gradual stretching, resistance and aerobic exercises, adapted to the individual clinical condition of each patient. The results showed significant improvement in cardio-circulatory parameters, as well as a significant decrease in scores on the fatigue scale. The success of this program led patients to ask to continue with it after the trial was finished, and more patients are enrolling in the program, motivated by the good results reported by fellow patients.     

Effects of aerobic exercise training and relaxation training on cardiovascular activity during psychological stress

Students who reported experiencing a high number of stressful life events were randomly assigned to: (a) an aerobic training condition, (b) a relaxation training condition, or (c) a no treatment control condition. Immediately before and after the 11 week training/control period, subjects' aerobic fitness and cardiovascular responses to acute psychological stress were assessed. Results indicated that: (1) subjects in the aerobic training condition showed significantly greater improvements in aerobic fitness than subjects in the other conditions, and (2) the subjects in the aerobic training condition showed significantly greater reductions in heart rate during all phases of the stress than subjects in the other conditions. Post-training differences between aerobic and control conditions during the moderate psychological stress were as great as 17 b.p.m. These results provide evidence for the utility of aerobic training for reducing cardiovascular activity during psychological stress, and they are consistent with earlier findings linking fitness to less illness following stress, reductions in depression and enhanced recovery in cardiac patients.     

Influence of initial aerobic fitness, aerobic training and changes in aerobic fitness on personality functioning

Data reflecting aerobic performance and personality functioning were obtained from 103 women before and after they participated in a 15 week aerobic training program. Regression and covariance analyses revealed that better personality functioning was reliably associated with higher initial levels of aerobic fitness, participation in the training program independent of changes in fitness, and with changes in fitness. However, different aspects of personality functioning were related to initial fitness, participation in training and changes in fitness.     

Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: a pilot study

Impaired mobility in multiple sclerosis (MS) is associated with high-energy costs and effort when walking, gait abnormalities, poor endurance and fatigue. This repeated measures trial with blinded assessments investigated the effect of treadmill walking at an aerobic training intensity in 16 adults with MS. The intervention consisted of 12 sessions of up to 30 minutes treadmill training (TT), at 55-85% of age-predicted maximum heart rate. The primary outcome measure was walking effort, measured by oxygen consumption (mL/kg per metre), during treadmill walking at comfortable walking speed (CWS). Associated changes in gait parameters using the 'Gait-Rite' mat, 10-m time and 2-minute distance, and Fatigue Severity Scale were examined. Following training, oxygen consumption decreased at rest (P = 0.008), CWS increased (P = 0.002), and 10-m times (P = 0.032) and walking endurance (P = 0.020) increased. At increased CWS, oxygen consumption decreased (P = 0.020), with a decreased time spent in stance in the weaker leg (P = 0.034), and a greater stride distance with the stronger leg (P = 0.044). Reported fatigue levels remained the same. Aerobic TT presents the opportunity to alter a motor skill and reduce the effort of walking, whilst addressing cardiovascular de-conditioning, thereby, potentially reducing effort and fatigue for some people with MS.     

Effects of aerobic fitness training on human cortical function: a proposal

We briefly review the extant human and animal literature on the influence of fitness training on brain, cognition and performance. The animal research provides clear support for neurochemical and structural changes in brain with fitness training. The human literature suggests reliable but process specific changes in cognition with fitness training for young and old adults. We describe a research program which examines the influence of aerobic fitness training on the functional activity of the human using event-related functional magnetic resonance imaging, of humans in fitness interventions.     

Cardiopulmonary and metabolic functions, aerobic capacity, fatigue and quality of life in patients with multiple sclerosis

OBJECTIVES: The objectives of this study were to evaluate cardiopulmonary and metabolic functions in patients with multiple sclerosis (MS) and to clarify the relationship between these functions and neurological deficits, respiratory involvement, fatigue and quality of life. MATERIALS AND METHODS: Twenty-five patients with MS and 15 healthy controls were included in the study. Cardiopulmonary and metabolic responses to maximum exercise were investigated with an electronically braked arm crank ergometer. A computerized gas analysis system collected and analysed expired gases during exercise. RESULTS: In the present study, significant respiratory muscle weakness, and decreased aerobic performance and cardiopulmonary and metabolic responses to maximum exercise were determined in patients with MS. CONCLUSIONS: As respiratory muscle function plays a strong role in aerobic capacity and in most of the cardiopulmonary and metabolic responses to exercise, measurement of respiratory muscle strength and endurance should also be carried out in the MS population.     

Exercise capacity, disability and leisure physical activity of subjects with multiple sclerosis

The purpose of the present study was to examine exercise capacity and its relationship to neurological disability as measured using the Expanded Disability Status Scale (EDSS) and to leisure physical activity in subjects with multiple sclerosis (MS). Thirty-four men and 61 women (mean age 44 +/- 6.7 years, mean disease duration 5.7 +/- 6.4 years) with mild to moderate disability (EDSS range 1.0-5.5) participated. They underwent an incremental exercise test on a leg cycling ergometer. Leisure physical activity was measured using a questionnaire. Peak oxygen uptake (VO2peak) in men was 27.0 +/- 5.2 mL/kg/min, and in women 21.7 +/- 5.5 mL/kg/min. The disability correlated inversely with the VO2peak both in men (r = - 0.50, P = 0.004) and in women (r = - 0.25, P = 0.05). No correlation between disease duration and VO2peak was found. In a multivariate regression analysis, neurological disability was confirmed as a predictor of VO2peak. No evidence of a relationship between leisure physical activity and VO2peak was found. A main finding was that disability and exercise capacity are inter-related, even in subjects who are not severely handicapped (84% had an EDSS of < 4.0). The level of disability should be taken into account in the planning of aerobic exercise programs for fully ambulatory MS subjects.     

Central motor drive and perception of effort during fatigue in multiple sclerosis

Objective To determine if task performance and fatiguability during repeated low-level contractions of an intrinsic hand muscle differ in a group of MS subjects compared with a control group, and what central changes accompany the development of fatigue and the period of recovery, whether these measures are related to subjective ratings of fatigue or perception of effort. Methods Force of index finger abduction, rating of perceived effort, and motor evoked potential amplitude and silent period duration were measured during and after a 20-min. intermittent submaximal (40%) contraction of the first dorsal interosseous muscle in 23 clinically definite MS subjects with mild-moderate symptoms, and 15 controls. Results Rating of perceived effort increased at a greater rate in the MS group than in control subjects during exercise, and this was associated with larger increases in both MEP amplitude and silent period duration. Conclusions Submaximal fatiguing exercise is associated with an enhanced central motor drive and increased perception of effort in MS. Significance MS subjects can increase central drive during fatiguing exercise to a greater degree than controls, but this is associated with greater perceived exertion. These factors may underlie the more general complaint of fatigue experienced by people with MS.