Whole-body cooling does not compromise muscle oxidative capacity in subjects with multiple sclerosis

Abstract

BACKGROUND: Whole-body cooling improves exercise tolerance in patients with multiple sclerosis (pwMS). To be able to exercise at greater intensities and/or for longer durations with whole-body cooling, it should be examined whether this compromises skeletal muscle oxidative capacity (assessed by exercise-onset VO 2 kinetics). OBJECTIVE: To study the impact of whole-body cooling on exercise-onset VO 2 kinetics in pwMS. METHODS: From 12 pwMS (EDSS 3.5 ± 1.5) and 12 healthy age, BMI, and gender-matched subjects exercise-onset VO 2 kinetics (mean response time [MRT]) and body temperature were determined under normothermic and hypothermic (pre-exercise 60-min whole-body cooling) conditions during submaximal exercise testing (two 6-min constant-load exercise bouts). Moreover, heart rate, blood lactate content, expiratory volume and ratings of perceived exertion (RPE) were assessed during exercise. RESULTS: Exercise heart rate (−7 ± 6 beats/min) and end-exercise body temperature (−0.9 ± 0.5 • C) was significantly lower in hypothermic vs. normothermic conditions in both populations (p < 0.05). In pwMS exercise RPE was lower in hypothermic vs. normothermic condition (p = 0.056). No significantly different MRT was found between normothermic vs. hypothermic conditions in both populations. CONCLUSIONS: Lowering body temperature prior to endurance exercise does not affect muscle oxidative capacity in pwMS, but lowers RPE, thus making it possible to prescribe exercises of greater intensity and/or longer duration.

Blood lactate concentrations during rest and exercise in people with Multiple Sclerosis: A systematic review and meta-analysis

“…With 1 exceptional outlier with a sample size totalling 1238 participants (613 with MS) [7], 6 studies had less than 30 participants [23][24][25]28,33,36], 9 studies had between 30 and 70 participants [17][18][19]26,27,29,32,34,35] and 2 studies had between 100-110 participants [30,31]. The total number of participants reported on across all studies was 1986; 1129 were participants with MS. 5 papers failed to adequately describe their methods adequately for study reproduction [23,24,30,31,33].…”

“…Overall AXIS scores may be found in Table 1. The most common sources of points being deducted (and implicit increase in risk of bias) included lack of information on or categorisation of non-responders [17][18][19]23,25,26,[28][29][30][31][33][34][35][36], lack of justification of sample size used within the study [24,29,30,[33][34][35], potential inherent bias within or lack of description of the population from which samples were recruited [17,19,[23][24][25][26]29,33,36], and inadequate descriptions of methodologies used within the studies to enable repetition in future research [23,24,28,30,33].…”

“…5 studies [18,23,27,31,34] did not specify which or how many phenotypes of MS they included in their studies. Of the of the remainder, all included a majority of participants with RR MS, 7 studies involved participants with PP MS [7,17,[24][25][26]29,36], 8 studies involved participants with SP MS [7,17,[24][25][26]29,32,36], 3 studies involved participants with CP MS [19,28,35], 3 studies involved 1 participant with PR MS [17,25,26] and 2 studies involved participants with an undisclosed MS phenotype [26,28].…”

Whole-body cryostimulation (cryotherapy) provides benefits for fatigue and functional status in multiple sclerosis patients. A case-control study

“…MS patients with fatigue syndrome seem to be especially sensitive when exposed to heat stress . In this context, cooling therapies have been shown to induce positive effects on the functional and mental status of patients with MS .…”

ASPIRE trial: study protocol for a double-blind randomised controlled trial of aspirin for overheating during exercise in multiple sclerosis

“…19 In pwMS, slight increases in body temperature may lead to prohibitive levels of exhaustion during exercise. As a response to this, several cooling methods (eg, ice baths, cooling contraptions or garments, cooled environments) developed for pwMS have effectively reduced fatigue 20 and improved exercise performance, [21][22][23][24][25] although such methods can be cumbersome, prohibitively expensive or unavailable. Also, it is important to note that none of these prior trials of cooling methods in MS were conducted using doubleblind study design.…”