Abstract
Patients with multiple sclerosis (MS) have an increased systemic vascular resistance (SVR) response during the metaboreflex. It has been hypothesized that this is the consequence of a sedentary lifestyle secondary to MS. The purpose of this study was to discover whether a 6-month training program could reverse this hemodynamic dysregulation. Patients were randomly assigned to one of the following two groups: the intervention group (MSIT, n = 11), who followed an adapted training program; and the control group (MSCTL, n = 10), who continued with their sedentary lifestyle. Cardiovascular response during the metaboreflex was evaluated using the post-exercise muscle ischemia (PEMI) method and during a control exercise recovery (CER) test. The difference in hemodynamic variables such as stroke volume (SV), cardiac output (CO), and SVR between the PEMI and the CER tests was calculated to assess the metaboreflex response. Moreover, physical capacity was measured during a cardiopulmonary test till exhaustion. All tests were repeated after 3 and 6 months (T3 and T6, respectively) from the beginning of the study. The main result was that the MSIT group substantially improved parameters related to physical capacity (+5.31 ± 5.12 ml·min−1/kg in maximal oxygen uptake at T6) in comparison with the MSCTL group (−0.97 ± 4.89 ml·min−1/kg at T6; group effect: p = 0.0004). However, none of the hemodynamic variables changed in response to the metaboreflex activation. It was concluded that a 6-month period of adapted physical training was unable to reverse the hemodynamic dys-regulation in response to metaboreflex activation in these patients.
Highlights
Exercise training is a well-established intervention to improve physical capacity in many types of diseases
Neurological examination was conducted and disability was evaluated according to the Expanded Disability Status scale (EDSS), which yielded an average value of 3.5 ± 0.7
Data shown are from 11 MSIT patients and 10 MSCTL patients
Summary
Exercise training is a well-established intervention to improve physical capacity in many types of diseases. Training has been found capable to improve physical capacity and quality of life in heart failure, to reduce blood pressure, Metaboreflex and Multiple Sclerosis to increase survival after infarction, and to increase insulin sensitivity (Pedersen and Saltin, 2015). Multiple Sclerosis (MS) has been found to be positively affected by physical exercise, as peak oxygen uptake and oxygen pulse were found improved after periods of training, thereby suggesting an increase exercise tolerance in these patients. Data on the effect of supervised physical training on hemodynamic regulation during exercise in MS patients are scarce
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