Marie Kierkegaard1, Ingrid E Lundberg2, Tomas Olsson3, Sverker Johansson4, Sofia Ygberg5, Christina Opava6, Lotta Widén Holmqvist7, Fredrik Piehl8. 1. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23 100, S-141 83 Huddinge, Sweden; Department of Physiotherapy, A6:U1, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Marie.Kierkegaard@ki.se. 2. Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, Karolinska Institutet, S-171 76, Stockholm, Sweden. Electronic address: Ingrid.Lundberg@ki.se. 3. Department of Clinical Neurosciences, K8, Karolinska Institutet, CMM L8:04, S-171 76 Stockholm, Sweden; Department of Neurology, R3:04, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Tomas.Olsson@ki.se. 4. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23 100, S-141 83 Huddinge, Sweden; Department of Physiotherapy, A6:U1, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Sverker.Johansson@ki.se. 5. Department of Women's and Children's Health, Karolinska Institutet, Elevhemmet H2:00, Karolinska University Hospital, S171 76 Stockholm, Sweden. Electronic address: Sofia.Ygberg@karolinska.se. 6. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23 100, S-141 83 Huddinge, Sweden; Department of Rheumatology, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Christina.Opava@ki.se. 7. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23 100, S-141 83 Huddinge, Sweden; Department of Physiotherapy, A6:U1, Karolinska University Hospital, S-171 76 Stockholm, Sweden; Department of Clinical Neurosciences, Division of Neurology, Karolinska Institutet, R54 Karolinska University Hospital, S-141 86 Stockholm, Sweden. Electronic address: Lotta.Holmqvist@ki.se. 8. Department of Clinical Neurosciences, K8, Karolinska Institutet, CMM L8:04, S-171 76 Stockholm, Sweden; Department of Neurology, R3:04, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Fredrik.Piehl@ki.se.
Abstract
BACKGROUND: High-intensity resistance training is unexplored in people with multiple sclerosis. OBJECTIVES: To evaluate effects of high-intensity resistance training on immune markers and on measures of mood, fatigue, health-related quality of life, muscle strength, walking and cognition. Further, to describe participants' opinion and perceived changes of the training. METHODS: Twenty patients with relapsing-remitting multiple sclerosis performed high-intensity resistance training at an intensity of 80% of one-repetition maximum, twice a week for 12 weeks. Blood and optional cerebrospinal fluid samples, and data on secondary outcome measures were collected before and after intervention. A study-specific questionnaire was used for capturing participants' opinion. RESULTS: Seventeen participants completed the study. Plasma cytokine levels of tumor necrosis factor were significantly decreased post-intervention (p=0.001). Exploratory cytokine analyses in cerebrospinal fluid (n=8) did not reveal major changes. Significant and clinically important improvements were found in fatigue (p=0.001) and health-related quality of life (p=0.004). Measures of mood (p=0.002), muscle strength (p ≤ 0.001), walking speed (p=0.013) and cognition (p=0.04) were also improved. A majority of participants evaluated the training as very good and perceived changes to the better. CONCLUSION: High-intensity resistance training in persons with relapsing remitting multiple sclerosis with low disability had positive effects on peripheral pro-inflammatory cytokine levels, led to clinically relevant improvements in measures of fatigue and health-related quality of life, and was well tolerated. These results provide a basis for a larger randomized trial.
BACKGROUND: High-intensity resistance training is unexplored in people with multiple sclerosis. OBJECTIVES: To evaluate effects of high-intensity resistance training on immune markers and on measures of mood, fatigue, health-related quality of life, muscle strength, walking and cognition. Further, to describe participants' opinion and perceived changes of the training. METHODS: Twenty patients with relapsing-remitting multiple sclerosis performed high-intensity resistance training at an intensity of 80% of one-repetition maximum, twice a week for 12 weeks. Blood and optional cerebrospinal fluid samples, and data on secondary outcome measures were collected before and after intervention. A study-specific questionnaire was used for capturing participants' opinion. RESULTS: Seventeen participants completed the study. Plasma cytokine levels of tumor necrosis factor were significantly decreased post-intervention (p=0.001). Exploratory cytokine analyses in cerebrospinal fluid (n=8) did not reveal major changes. Significant and clinically important improvements were found in fatigue (p=0.001) and health-related quality of life (p=0.004). Measures of mood (p=0.002), muscle strength (p ≤ 0.001), walking speed (p=0.013) and cognition (p=0.04) were also improved. A majority of participants evaluated the training as very good and perceived changes to the better. CONCLUSION: High-intensity resistance training in persons with relapsing remitting multiple sclerosis with low disability had positive effects on peripheral pro-inflammatory cytokine levels, led to clinically relevant improvements in measures of fatigue and health-related quality of life, and was well tolerated. These results provide a basis for a larger randomized trial.
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