Abstract
Background: Quantification of training intensities via current formulas (e.g. 75% of the estimated maximum heart rate (HR-peak)) is practical and a time saving compromise. However misinterpretations of cardiorespiratory fitness in persons with MS (pwMS) may lead to stagnancy or loss of exercise capacity. Objectives: Feasibility of different training intensities of established training formulas in pwMS using a method comparison according to Bland-Altman. Methods: 83 pwMS were included and the thresholds were determined via breathing gas analysis of peak oxygen consumption (VO2) and carbondioxide (CO2). The sample was divided according to the expandend disability status scale (EDSS) in mildly (EDSS 1.0-4.0) and moderately impaired (EDSS 4.5 - 6.5). The formulas (210 age)*0.65, (210-age)*0.70, (210-age)*0.80, 180-age, 65% of the effective highest heart rate during CPET (HRPeak), 70%HR-peak, 75% HR-peak and 80% HR-peak were used for the estimation of the training heart rates. Method comparisons were performed using Passing-Bablok regression and Bland-Altman plots. All values are expressed as mean and 95% confidence interval (CI). Results: Passing-Bablok regression show that for mildly impaired pwMS 70% and 75% HR-peak show an agreement with the threshold values. For severely impaired pwMS 65% HR-peak showed by trend an agreement with the threshold values. Other formula values missed the criteria for agreement. Conclusion: This study indicates that 70% and 75% HR-peak for moderately impaired PwMS gave adequate training intensities comparable to the threshold values.
Highlights
MS is a chronic disease of the central nervous system, accompanied by varying inflammatory manifestations, demyelization and axonal loss [1]
This study indicates that 70% and 75% HR-peak for moderately impaired persons with MS (PwMS) gave adequate training intensities comparable to the threshold values
Data of this study indicate that the training intensities quantified via current formulas are not suitable for persons with MS (pwMS) as the formulas mainly overestimated the target range specified through the threshold values obtained by cardiopulmonary exercise test (CPET)
Summary
MS is a chronic disease of the central nervous system, accompanied by varying inflammatory manifestations, demyelization and axonal loss [1]. With chronic progressive or relapsing-remitting disease onsets persons with MS (PwMS) progressively develop impaired functional capacity and show reduced physical activity compared to healthy controls [2]. Findings show that the degree of impairments are not primarily due to the disease itself but for the most part due to secondary causes like inactivation that further decrease health status of PwMS [3]. Exercise ranges from passive physiotherapy-based interventions to submaximal endurance training sessions. It has become clear that an eventual worsening of the sensory symptoms – expressed by 40% of PwMS – is temporal and will normalize in within half an hour after the exercise session [8,9]. Misinterpretations of cardiorespiratory fitness in persons with MS (pwMS) may lead to stagnancy or loss of exercise capacity
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