The Influence of HIIT Versus MCT on Cardiorespiratory Fitness in PPMS
The Influence of High-Intensity Interval Training Compared to Moderate Continuous Training on Cardiorespiratory Fitness, Symptom Improvement, and Disease-specific Biomarkers in Primary Progressive Multiple Sclerosis
What it found
A paper reports the results; we have not read it yet. See Papers below.
What was tested
Treatment tested
- HIIT
Compared with
- MCT
What it measured
Main measures
Cardiorespiratory fitness (peak oxygen consumption, VO2peak)
Three weeks (day 0 to day 21)
Physical function
Other measures (10)
Peak power output (PPO)
Three weeks (day 0 to day 21)
Cognitive performance
Three weeks (day 0 to day 21)
Thinking and memoryCognitive impairment at baseline
Baseline (day 0)
Thinking and memoryWalking capacity
Three weeks (day 0 to day 21)
Walking and mobilityPhysical and psychological Impairment
Three weeks (day 0 to day 21)
Quality of life (reported by participants)Fatigue
Three weeks (day 0 to day 21)
Thinking and memoryFatigueAnxiety and depressive symptoms
Three weeks (day 0 to day 21)
Mood and sleepKynurenine pathway (KP) metabolites
Three weeks (day 0 to day 21)
Physical functionImmune status (blood cells)
Time Frame: Three weeks (day 0 to day 21)
Thinking and memoryPhysical functionImmune responseImmune status (pro-inflammatory cytokines)
Time Frame: Three weeks (day 0 to day 21)
Physical functionImmune responseHow the body handles the medicine
Who could take part
Progressive MS · 18 and over
Show the full criteria
Inclusion criteria
* adult age (≥ 18 years) * definite MS diagnosis according the 2017 revised McDonald criteria * disease course: PPMS according to the 2013 revised Lublin criteria * disease severity: Expanded Disability Status Scale (EDSS) score ≤ 6.0 * Informed Consent as documented by signature of participants and PI
Exclusion criteria
* Persons suffering from severe lower extremity spasticity or severe concomitant ´ disease states (i.e., orthopaedic, cardiovascular, metabolic, psychiatric (e.g., substance abuse), other neurological, other serious medical conditions) impairing their ability to participate. * Persons regularly performing HIIT (2-3 times per week) * Inability to follow the procedures of the study due to language problems (i.e., participant not fluent in oral and written German language) * Changes in disease-modifying drugs (≤ 6 weeks) * Immunosuppressive therapy (i.e., corticosteroids) (≤ 4 weeks) * Stem cell treatment (≤ 6 months) * Pregnant or breast-feeding women * Intention to become pregnant during the course of the study * Suspected non-compliance * Previous enrolment into the current study * Enrolment of the investigator, his/her family members, employees, and other dependent persons * occurrence of severe pulmonary or cardiovascular decompensations (i.e., blood pressure (Riva Rocci) > 240/120, HR ≥ HRmax (220-years of age) (e.g. due to renal failure, hepatic dysfunction, cardiovascular disease) * abnormalities in electrocardiography (ECG), pulse oximetry, or spirometry during initial CPET
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
Endurance training revealed to be an effective means to increase cardiorespiratory fitness in persons with Multiple Sclerosis (MS), considered relevant to health-related quality of life in this population. Moreover, endurance training improves MS-related symptoms, such as reduced walking capacity, fatigue, depression, and cognitive impairment. Owing to these benefits, endurance training has evolved as an integral part of MS rehabilitation, anchored in current treatment guidelines. In recent years, High-Intensity Interval training (HIIT) evolved as a time-efficient and safe alternative to standard care in MS rehabilitation that is Moderate Continuous Training (MCT). Indeed, HIIT has already been proven superior to MCT in improving cardiorespiratory fitness, MS-related symptoms (e.g. cognitive impairment) and, beyond, seems to elicit disease-modifying effects on MS-pathophysiology (i.e. alleviated neuroinflammation and neurodegeneration). However, current evidence is restricted to clinical trials that include samples with mixed MS disease courses, in which persons with primary progressive MS (PPMS) are underrepresented due to comparatively low prevalence rates. Distinct pathophysiological mechanisms and symptom constellations prohibit the generalisation of previous findings to persons with PPMS. In this population, however, evidence-based rehabilitative strategies are urgently needed, as disability progression in PPMS is poorly responsive to pharmacotherapy. This study, aims to validate previous findings on the superior effect of HIIT compared to MCT on improving cardiorespiratory fitness, MS-related symptoms and MS pathophysiology in persons with PPMS, contributing to the development of specific recommendations to maximize the effects of exercise as a potent non-pharmacological treatment adjuvant.
Papers
Results
Cycling in primary progressive multiple sclerosis (CYPRO): study protocol for a randomized controlled superiority trial evaluating the effects of high-intensity interval training in persons with primary progressive multiple sclerosis.BMC Neurol · 2023
Results
Bansi J, Koliamitra C, Bloch W, Joisten N, Schenk A, Watson M, Kool J, Langdon D, Dalgas U, Kesselring J, Zimmer P. Persons with secondary progressive and relapsing remitting multiple sclerosis reveal different responses of tryptophan metabolism to acute endurance exercise and training. J Neuroimmunol. 2018 Jan 15;314:101-105. doi: 10.1016/j.jneuroim.2017.12.001. Epub 2017 Dec 6.Results
Zimmer P, Bloch W, Schenk A, Oberste M, Riedel S, Kool J, Langdon D, Dalgas U, Kesselring J, Bansi J. High-intensity interval exercise improves cognitive performance and reduces matrix metalloproteinases-2 serum levels in persons with multiple sclerosis: A randomized controlled trial. Mult Scler. 2018 Oct;24(12):1635-1644. doi: 10.1177/1352458517728342. Epub 2017 Aug 21.Results
Joisten N, Proschinger S, Rademacher A, Schenk A, Bloch W, Warnke C, Gonzenbach R, Kool J, Bansi J, Zimmer P. High-intensity interval training reduces neutrophil-to-lymphocyte ratio in persons with multiple sclerosis during inpatient rehabilitation. Mult Scler. 2021 Jun;27(7):1136-1139. doi: 10.1177/1352458520951382. Epub 2020 Sep 3.Results
Joisten N, Rademacher A, Warnke C, Proschinger S, Schenk A, Walzik D, Knoop A, Thevis M, Steffen F, Bittner S, Gonzenbach R, Kool J, Bloch W, Bansi J, Zimmer P. Exercise Diminishes Plasma Neurofilament Light Chain and Reroutes the Kynurenine Pathway in Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm. 2021 Mar 29;8(3):e982. doi: 10.1212/NXI.0000000000000982. Print 2021 May.Results
Lea Schlagheck M, Wucherer A, Rademacher A, Joisten N, Proschinger S, Walzik D, Bloch W, Kool J, Gonzenbach R, Bansi J, Zimmer P. VO2peak Response Heterogeneity in Persons with Multiple Sclerosis: To HIIT or Not to HIIT? Int J Sports Med. 2021 Dec;42(14):1319-1328. doi: 10.1055/a-1481-8639. Epub 2021 Jul 1.Results
Rademacher A, Joisten N, Proschinger S, Hebchen J, Schlagheck ML, Bloch W, Gonzenbach R, Kool J, Bansi J, Zimmer P. Do baseline cognitive status, participant specific characteristics and EDSS impact changes of cognitive performance following aerobic exercise intervention in multiple sclerosis? Mult Scler Relat Disord. 2021 Jun;51:102905. doi: 10.1016/j.msard.2021.102905. Epub 2021 Mar 18.Results
Rademacher A, Joisten N, Proschinger S, Bloch W, Gonzenbach R, Kool J, Langdon D, Bansi J, Zimmer P. Cognitive Impairment Impacts Exercise Effects on Cognition in Multiple Sclerosis. Front Neurol. 2021 Jan 28;11:619500. doi: 10.3389/fneur.2020.619500. eCollection 2020.
Loading reviews and guidelines…
History
Started
May 2022
Main results due
Feb 2024
Finished
Feb 2024