Heat sensitive persons with multiple sclerosis are more tolerant to resistance exercise than to endurance exercise

Abstract

Background: Heat sensitivity (HS) is reported by 58% of all persons with multiple sclerosis (MS), causing symptom exacerbation possibly limiting exercise participation. Objective: The purpose of this study was to test the hypotheses that (a) a relationship between exercise-induced changes in core–temperature (Ctemp) and changes in symptom intensity exists, and (b) that resistance exercise (RE), as a consequence of a minor increase in core temperature, will induce a lesser worsening of symptoms than endurance exercise (EE) in HS persons with MS. Methods: On two separate days, 16 HS persons with MS randomly completed a session of RE and EE, or EE and RE, respectively. Testing was conducted pre, post and one hour after exercise and consisted of Visual Analogue Scale (VAS) scoring (fatigue, spasticity, pain, strength, walking and balance), the 5-time sit-to-stand (5STS), the Multiple Sclerosis Functional Composite (MSFC) and Body Sway. Composite scores describing average subjective symptom intensity (SI) and total number of symptoms (SN) were calculated from VAS scores. Results: Ctemp (0.9±0.4°C vs 0.3±0.1°C, p<0.001), SI (1.7±1.9 cm vs 0.6±1.5 cm, p<0.05) and SN (1.6±1.9 vs 0.6±2.1, p<0.05) increased significantly more during EE than RE. Changes in Ctemp correlated to changes in SI (r=0.50, p<0.01). No differences were observed in 5STS, MSFC and Body Sway scores after EE when compared to RE. Conclusion: An exercise-induced increase in Ctemp is associated with increased number and severity of perceived symptoms in HS persons with MS. Based on these findings it is expected that HS persons with MS do tolerate RE better than EE.