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Periodized versus classic exercise therapy in Multiple Sclerosis: a randomized controlled trial

  • Charly Keytsman
    Correspondence
    Corresponding author: REVAL Rehabilitation Center – Biomedical Research Institute (BIOMED) – Hasselt University, Agoralaan Building A, B-3590 Diepenbeek, Belgium.
    Affiliations
    REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium

    BIOMED Biomedical Research Institute, Hasselt University, Agoralaan Building A, B-3590, Diepenbeek, Belgium
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  • Pieter Van Noten
    Affiliations
    REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium

    BIOMED Biomedical Research Institute, Hasselt University, Agoralaan Building A, B-3590, Diepenbeek, Belgium
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  • Kenneth Verboven
    Affiliations
    REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium

    BIOMED Biomedical Research Institute, Hasselt University, Agoralaan Building A, B-3590, Diepenbeek, Belgium
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  • Paul Van Asch
    Affiliations
    Move to Sport Foundation, Mechelsesteenweg, Kontich, Belgium
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  • Bert O Eijnde
    Affiliations
    BIOMED Biomedical Research Institute, Hasselt University, Agoralaan Building A, B-3590, Diepenbeek, Belgium

    Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
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Published:January 19, 2021DOI:https://doi.org/10.1016/j.msard.2021.102782

      Highlights

      • Periodizing exercise in MS shows good high intensity exercise training adherence.
      • Unknown if this induces similar training results compared to conventional programs.
      • Periodized exercise induced better results on aerobic capacity compared to classic training in MS.

      Abstract

      Background

      Periodizing exercise interventions in Multiple Sclerosis (MS) shows good high intensity exercise training adherence. Whether this approach induces comparable training adaptations with respect to exercise capacity, body composition and muscle strength compared to conventional, linear progressive training programs however is not known.

      Methods

      Thirty-one persons with MS (all phenotypes, mean EDSS 2.3±1.3) were randomized into a twelve-week periodized (MSPER, n=17) or a classic endurance (MSCLA, n=14) training program. At baseline (PRE), exercise capacity (maximal exercise test, VO2max), body composition (DEXA) and muscle strength (Biodex®) were assessed. Classic, moderate intensity endurance training (60-80% HRmax, 5 training sessions/2w, 60min/session) was performed on a stationary bicycle. Periodized exercise included 4 recurrent 3-week cycles of alternated endurance training (week 1: endurance training as described above), high intense exercise (week 2: 3 sessions/w, 3 × 20s all-out sprints, 10min/session) and recovery weeks (week 3: one sprint session as described above). POST measurements were performed similar to baseline. Total exercise volume of both programs was expressed as total peak-effort training minutes.

      Results

      For MSCLA, total exercise volume included 1728 total peak-effort training minutes, whereas MSPER included only 736. Despite this substantially reduced training volume, twelve weeks of periodized training significantly (p<0.05) improved VO2max (+14%, p=0.001), workload (+20%) and time until exhaustion (+25%). Classic training significantly (p<0.05) improved workload (+10%) and time until exhaustion (+17%), but not VO2max (+5%, p=0.131). Pre-post improvements for VO2max were significantly higher in MSPER compared to MSCLA (p=0.046).

      Conclusion

      These data show that despite substantially lower training time (57% less peak-effort training minutes), 12 weeks of periodized exercise training in persons with MS seems to induce larger improvements in parameters of exercise capacity compared to classic endurance training. We therefore recommend to further investigate the effect of training periodization on various functional rehabilitation measures in MS.

      Keywords

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