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Effects of a cooling vest with sham condition on walking capacity in heat-sensitive people with Multiple Sclerosis

Abstract

Purpose

Heat sensitivity is a common contraindication in people with Multiple Sclerosis (pwMS), and physical fatigue is one of the most frequently reported symptoms that can affect quality of life. Increases in body temperature may exacerbate fatigue and heat-related symptoms. Decreasing body temperature via cooling devices may mitigate disease symptoms and improve physical abilities and quality of life. This study evaluates the effects of a cooling vest with sham condition on walking capacity using a commercially-available cooling vest specifically designed for pwMS.

Methods

A counter-balanced, cross-over design was used to assess the effects of a cooling vest (CryoVest Comfort, CryoInnov, France) (COLD) from a menthol-induced sham condition (CON) on ground walking time to exhaustion (Tex, s) and distance at exhaustion (Dex, m) in ambulatory pwMS. Secondary outcomes were heart rate (HR, bpm), thermal sensation (Tsens), skin chest (Tchest) and back (Tback) temperature.

Results

Ten females with Multiple Sclerosis (59 ± 9 years, EDSS 3.0–5.5) participated to the study. During COLD, pwMS walked significantly longer (1896 ± 602 vs. 1399 ± 404 s, p < 0.001) and farther (1879 ± 539 vs. 1302 ± 318 m, p < 0.001) than CON. Importantly, Tsens and HR at exhaustion were not significantly different between conditions, although Tchest (− 2.7 ± 1.8 °C, p < 0.01) and Tback (− 3.9 ± 1.8 °C, p < 0.001) were lower at volitional fatigue during COLD.

Conclusion

The lightweight cooling vest improved total walking time and distance in heat-sensitive pwMS. These physiological improvements were likely due to feeling perceptually cooler in the COLD trial, compared to the corresponding point of fatigue in the CON condition.

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Fig. 1
Fig. 2

Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to IRB/EC requirements, but are available from the corresponding author on reasonable request.

Abbreviations

6MWT:

6 Min walking test

ANOVA:

Analysis of variance

COLD:

Cold vest condition

CON:

Control condition

CWS:

Comfortable walking speed

D ex :

Distance to exhaustion

EDSS:

Expanded disability status scale

HR:

Heart rate

MS:

Multiple Sclerosis

PP:

Primary progressive

pwMS:

People with Multiple Sclerosis

RH:

Relative humidity

RR:

Relapsing remitting

T :

Time (different time points during the exercise)

T25-FW:

Timed 25-Foot Walk

Tback:

Mid-scapular skin temperature

Tchest:

Mid-pectoral skin temperature

Tcom:

Thermal comfort

T ex :

Time to exhaustion

Tsens:

Thermal sensation

TUG:

Timed up and go

VAS:

Visual analog scale

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Funding

This study was funded by Fondazione Cassa di Risparmio di Trieste (09/2018).

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Authors

Contributions

ABS: conceptualization; data curation; formal analysis; funding acquisition; investigation; methodology; resources; visualization; roles/writing—original draft; writing review and editing. FP: conceptualization; investigation; methodology; validation; roles/writing—original draft; writing—review and editing. SAM: conceptualization; data curation; methodology; resources; software; supervision; validation; writing—review and editing. MEM: conceptualization; methodology; validation; writing—review and editing. AD: investigation; methodology; writing—review and editing. AB: investigation; methodology; resources; supervision; writing—review and editing. AB: methodology; resources; supervision; writing—review and editing. AS: conceptualization; data curation; funding acquisition; investigation; methodology; resources; supervision; validation; roles/writing—original draft; writing—review and editing. FG: data curation; formal analysis; software; validation; visualization; roles/writing—original draft; writing—review and editing. PM: conceptualization; data curation; funding acquisition; methodology; project administration; resources; supervision; validation; writing—review and editing.

Corresponding author

Correspondence to Alex Buoite Stella.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board of the “Azienda Sanitaria Universitaria Giuliana Isontina” and the Ethics Board of Friuli-Venezia Giulia. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Buoite Stella, A., Pasquin, F., Morrison, S.A. et al. Effects of a cooling vest with sham condition on walking capacity in heat-sensitive people with Multiple Sclerosis. Eur J Appl Physiol 120, 2467–2476 (2020). https://doi.org/10.1007/s00421-020-04478-3

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Keywords

  • Fatigue
  • Cooling
  • Multiple Sclerosis
  • Walking
  • Uhthoff phenomenon