Efficacy of high-intensity aerobic exercise on cognitive performance in people with multiple sclerosis: A randomized controlled trial

Langeskov‐Christensen, Martin; Hvid, Lars G.; Jensen, Henrik Boye; Nielsen, Helle Hvilsted; Petersen, Thor; Stenager, Egon; Hämäläinen, Päivi; Dalgas, Ulrik

doi:10.1177/1352458520973619

Cited by 21 publications

(11 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, with regard to the subgroup analysis, no group (HIIT vs. CG) effect could be observed, which also indicates no superiority of one exercise regime with regard to cognitive performance. A recently published secondary analysis investigated the effects of a highintensity aerobic exercise intervention compared to a waitlist control condition on cognitive performance in pwMS, thereby analyzing effects on both the overall sample and a cognitive impaired subsample (29). Results show similar effects to the present analysis, as no interaction effects were observed for the overall analysis.…”

Section: Discussionsupporting

confidence: 64%

Cognitive Impairment Impacts Exercise Effects on Cognition in Multiple Sclerosis

et al. 2021

View full text Add to dashboard Cite

Purpose: Exercise training reveals high potential to beneficially impact cognitive performance in persons with multiple sclerosis (pwMS). Research indicates that high-intensity interval training (HIIT) has potentially higher effects on physical fitness and cognition compared to moderate continuous exercise. This study (i) compares the effects of a 3-week HIIT and moderate continuous exercise training on cognitive performance and cardiorespiratory fitness of pwMS in an overall analysis and (ii) investigates potential effects based on baseline cognitive status in a subgroup analysis.Methods: Seventy-five pwMS were randomly assigned to an intervention (HIIT: 5 × 1.5-min intervals at 95–100% HRmax, 3 ×/week) or active control group (CG: 24 min continuous exercise at 65% HRmax, 3 ×/week). Cognitive performance was assessed pre- and post-intervention with the Brief International Cognitive Assessment for MS (BICAMS). (I) To examine potential within (time) and interaction (time × group) effects in the overall analysis, separate analyses of covariance (ANCOVA) were conducted. (II) For the subgroup analysis, participants were divided into two groups [intact cognition or impaired cognition (>1.5 standard deviation (SD) compared to healthy, age-matched norm data in at least one of the three tests of the BICAMS]. Potential impacts of cognitive status and intervention were investigated with multivariate analyses of variance (MANOVA).Results: Overall analysis revealed significant time effects for processing speed, verbal learning, rel. VO2peak, and rel. power output. A time*group interaction effect was observed for rel. power output. Subgroup analysis indicated a significant main effect for cognition (impaired cognition vs. intact cognition). Subsequent post-hoc analysis showed significant larger effects on verbal learning in pwMS with impaired cognition.Conclusion: Current results need to be confirmed in a powered randomized controlled trial with cognitive performance as primary endpoint and eligibility based on cognitive performance that is assessed prior to study inclusion.

show abstract

Section: Discussionsupporting

confidence: 64%

Cognitive Impairment Impacts Exercise Effects on Cognition in Multiple Sclerosis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…When compared with a waitlist group, the cognitively impaired subgroup showed an improvement of the SDMT and Selective Reminding Test (SRT) after PAE. No effects were found in other tests both in the cognitively impaired subgroup and in the whole group, failing to show a clear correlation between changes in cardiorespiratory fitness and global cognitive performance in pwMS [129].…”

Section: Clinical Impact Of Exercise In Patients With Multiple Sclerosismentioning

confidence: 62%

“…Most of the researchers highlighted critical issues explaining these conflicting results such as methodological limitations such as inadequate samples, the fact that the enrolled patients did not always have an overt cognitive impairment [132,133], unsupervised sessions of several exercise modalities, low intensity and short duration of exercise (<12 weeks) [132], along with the application of single or several cognitive tests rather than a unique and validated neuropsychological battery [129]. To date, direct comparison between studies is challenging and, when compared, divergent results are obtained.…”

Section: Clinical Impact Of Exercise In Patients With Multiple Sclerosismentioning

confidence: 99%

The Role of Nutritional Lifestyle and Physical Activity in Multiple Sclerosis Pathogenesis and Management: A Narrative Review

et al. 2021

View full text Add to dashboard Cite

Studies on the role of nutritional factors and physical activity (PA) in the pathogenesis of multiple sclerosis (MS) go back a long time. Despite the intrinsic difficulty of studying their positive or negative role in MS, the interest of researchers on these topics increased during the last few decades, since the role of diet has been investigated with the perspective of the association with disease-modifying drugs (DMD). The association of DMD, diets, and PA might have an additive effect in modifying disease severity. Among the various diets investigated (low-carbohydrate, gluten-free, Mediterranean, low-fat, fasting-mimicking, and Western diets) only low-carbohydrate, Mediterranean, and fast-mimicking diets have shown both in animal models and in humans a positive effect on MS course and in patient-reported outcomes (PROs). However, the Mediterranean diet is easier to be maintained compared to fast-mimicking and low-carbohydrate diets, which may lead to detrimental side effects requiring careful clinical monitoring. Conversely, the Western diet, which is characterized by a high intake of highly saturated fats and carbohydrates, may lead to the activation of pro-inflammatory immune pathways and is therefore not recommended. PA showed a positive effect both in animal models as well as on disease course and PROs in humans. Training with combined exercises is considered the more effective approach.

show abstract

“…The primary analysis of this trial, investigating the effect of PAE on brain atrophy outcomes, has previously been published elsewhere (also covering study design and participants, flowchart, adherence data, baseline characteristics, and Six‐Minute Walk Test (6MWT) and cardiorespiratory fitness (VO 2 max) data) 18 . Furthermore, a cross‐sectional study (baseline data) 19 examining associations between cardiorespiratory fitness and cognitive performance and a longitudinal study examining the effect of PAE on cognitive performance 20 have also previously been published from the trial.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of high‐intensity aerobic exercise on common multiple sclerosis symptoms

Langeskov‐Christensen

Hvid

Jensen

et al. 2021

Acta Neuro Scandinavica

Self Cite

View full text Add to dashboard Cite

Objectives Fatigue and walking impairment are disabling symptoms of multiple sclerosis (MS). We investigated the effects of progressive aerobic exercise (PAE) on fatigue, walking, cardiorespiratory fitness (VO2max), and quality of life in people with MS (pwMS). Materials & Methods Randomized controlled trial (1:1 ratio, stratified by sex) with a 24‐week crossover follow‐up and intention‐to‐treat analysis. Allocation to an exercise (24 weeks of PAE followed by self‐guided physical activity) and a waitlist (24 weeks of habitual lifestyle followed by PAE) group. PAE comprised two supervised sessions per week; 30–60 min, 65–95% of maximum heart rate. Fatigue impact (Modified Fatigue Impact Scale; MFIS) and severity (Fatigue Severity Scale; FSS), walking ability (12‐item MS Walking Scale; MSWS‐12) and capacity (Six‐Minute Walk Test; 6MWT, Six Spot Step Test; SSST), quality of life (Short Form 36 health survey; SF‐36), and VO2max were measured at baseline, 24 weeks, and 48 weeks. Results Eighty‐six pwMS were enrolled. Following PAE between‐group differences showed reductions in MFIStotal (−5.3 [95% CI: −10.9;0.4], point estimate >clinical relevance), MFISphysical subscore (−2.8 [−5.6;‐0.1]), and MFISpsychosocial subscore (−0.9 [−1.6;‐0.2]), and an increase in VO2max (+3.5 ml O2/min/kg [2.0;5.1]). MSWS‐12 (−5.9 [−11.9; 0.2]) and 6MWT (+14 m [−5;33]) differences suggested potential small walking improvements. No changes observed in FSS, SSST, or SF‐36. Conclusions In a representative sample of pwMS, PAE induced a clinically relevant reduction in fatigue impact, whereas small and no effects were seen for walking and quality of life, respectively. The results need confirmation in a future trial due to the study limitations.

show abstract

Efficacy of high-intensity aerobic exercise on cognitive performance in people with multiple sclerosis: A randomized controlled trial

Cited by 21 publications

References 38 publications

Cognitive Impairment Impacts Exercise Effects on Cognition in Multiple Sclerosis

Cognitive Impairment Impacts Exercise Effects on Cognition in Multiple Sclerosis

The Role of Nutritional Lifestyle and Physical Activity in Multiple Sclerosis Pathogenesis and Management: A Narrative Review

Efficacy of high‐intensity aerobic exercise on common multiple sclerosis symptoms

Contact Info

Product

Resources

About