Skip to main content
SpringerLink
Log in

High-intensity interval ergometer training improves aerobic capacity and fatigue in patients with multiple sclerosis

  • Original Article
  • Published:
Sport Sciences for Health Aims and scope Submit manuscript

Abstract

Background

Moderate endurance training leads to a significant improvement of aerobic fitness and fatigue in patients with multiple sclerosis (MS). However, the effects of high-intensity interval training (HIIT) have not systematically investigated.

Aim

To determine the effects of short-term HIIT on aerobic fitness and fatigue in MS patients.

Design

Prospective monocentric, randomized, simple blinded cohort study.

Settings

Participants exercised for 8 weeks on a bicycle ergometer three times weekly for 8 weeks.

Population

Forty patients with relapsing–remitting MS and an extended disability status score (EDSS) of < 3.5 participated.

Methods

For 8 weeks, participants exercised three times weekly for 30 min according to two different protocols (HIIT versus moderate endurance training). Measurements were taken at baseline and after 8 weeks of training. Individual aerobic fitness (VO2peak) was assessed via a stepwise ramp protocol, fatigue by the Fatigue Severity Scale (FSS), and ambulation was measured by the Timed 25-Foot Walk Test (T25-FW). Data were analysed according to the intention-to-treat (ITT) approach.

Results

Aerobic fitness increased significantly in the HIIT group (pre: 26.7 ± 6.1, post: 29.7 ± 6.6 ml/min/kg; p < 0.04). No changes with regard to FSS and T25FW were detected in both groups. However, sub-group analysis revealed a significant decrease of fatigue in patients with elevated baseline fatigue (pre: 5.00 ± 0.7, post: 4.7 ± 1.2; p = 0.03).

Conclusions

HIIT is a promising time-efficient approach in subjects with MS leading to rapid improvement of aerobic fitness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

HIIT:

High-intensity interval training

MS:

Multiple sclerosis

EDSS:

Extended disability status score

FSS:

Fatigue Severity Scale

T25-FW:

Timed 25-foot walk Test

ITT:

Intention-to-treat

VO2max:

Maximum aerobic capacity

MT:

Moderate training

References

  1. Klaren RE, Motl RW, Dlugonski D et al (2013) Objectively quantified physical activity in persons with multiple sclerosis. Arch Phys Med Rehabil 94(12):2342–2348. https://doi.org/10.1016/j.apmr.2013.07.011

    Article  PubMed  Google Scholar 

  2. Sandroff BM, Dlugonski D, Weikert M et al (2012) Physical activity and multiple sclerosis: new insights regarding inactivity. Acta Neurol Scand 126(4):256–262. https://doi.org/10.1111/j.1600-0404.2011.01634.x

    Article  CAS  PubMed  Google Scholar 

  3. Béthoux F (2006) Fatigue et sclérose en plaques. Annales de Réadaptation et de Médecine Physique 49(6): 265–271. https://doi.org/10.1016/j.annrmp.2006.04.023

    Article  PubMed  Google Scholar 

  4. Kayes NM, McPherson KM, Taylor D et al (2011) Facilitators and barriers to engagement in physical activity for people with multiple sclerosis: a qualitative investigation. Disabil Rehabil 33(8):625–642. https://doi.org/10.3109/09638288.2010.505992

    Article  PubMed  Google Scholar 

  5. Motl RW, Pilutti LA (2012) The benefits of exercise training in multiple sclerosis. Nat Rev Neurol 8(9):487–497. https://doi.org/10.1038/nrneurol.2012.136

    Article  PubMed  Google Scholar 

  6. Pilutti LA, Greenlee TA, Motl RW et al (2013) Effects of exercise training on fatigue in multiple sclerosis: a meta-analysis. Psychosom Med 75(6):575–580. https://doi.org/10.1097/PSY.0b013e31829b4525

    Article  CAS  PubMed  Google Scholar 

  7. Bjarnadottir OH, Konradsdottir AD, Reynisdottir K et al (2007) Multiple sclerosis and brief moderate exercise. A randomised study. Mult Scler 13(6):776–782. https://doi.org/10.1177/1352458506073780

    Article  CAS  PubMed  Google Scholar 

  8. Petajan JH, Gappmaier E, White AT et al (1996) Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 39(4):432–441. https://doi.org/10.1002/ana.410390405

    Article  CAS  PubMed  Google Scholar 

  9. Ponichtera-Mulcare JA (1993) Exercise and multiple sclerosis. Med Sci Sports Exerc 25(4):451–465

    CAS  PubMed  Google Scholar 

  10. Rampello A, Franceschini M, Piepoli M et al (2007) Effect of aerobic training on walking capacity and maximal exercise tolerance in patients with multiple sclerosis: a randomized crossover controlled study. Phys Ther 87(5):545–555. https://doi.org/10.2522/ptj.20060085

    Article  PubMed  Google Scholar 

  11. Schmidt S, Wonneberger M (2014) Long-term endurance exercise improves aerobic capacity in patients with relapsing-remitting multiple sclerosis: impact of baseline fatigue. J Neurol Sci 336(1–2):29–35. https://doi.org/10.1016/j.jns.2013.09.035

    Article  PubMed  Google Scholar 

  12. Gormley SE, Swain DP, High R et al (2008) Effect of intensity of aerobic training on VO2max. Med Sci Sports Exerc 40(7):1336–1343. https://doi.org/10.1249/MSS.0b013e31816c4839

    Article  PubMed  Google Scholar 

  13. Helgerud J, Høydal K, Wang E et al (2007) Aerobic high-intensity intervals improve VO2max more than moderate training. Med Sci Sports Exerc 39(4):665–671. https://doi.org/10.1249/mss.0b013e3180304570

    Article  PubMed  Google Scholar 

  14. Shiraev T, Barclay G (2012) Evidence based exercise—clinical benefits of high intensity interval training. Aust Fam Physician 41(12):960–962

    PubMed  Google Scholar 

  15. Campbell E, Coulter EH, Paul L (2018) High intensity interval training for people with multiple sclerosis: a systematic review. Mult Scler Relat Disord 24:55–63. https://doi.org/10.1016/j.msard.2018.06.005

    Article  PubMed  Google Scholar 

  16. Wens I, Dalgas U, Vandenabeele F et al (2015) High intensity exercise in multiple sclerosis: effects on muscle contractile characteristics and exercise capacity, a randomised controlled trial. PLoS One 10(9):e0133697. https://doi.org/10.1371/journal.pone.0133697

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Collett J, Dawes H, Meaney A et al (2011) Exercise for multiple sclerosis: a single-blind randomized trial comparing three exercise intensities. Mult Scler J 17(5):594–603. https://doi.org/10.1177/1352458510391836

    Article  Google Scholar 

  18. Ross LM, Porter RR, Durstine JL (2016) High-intensity interval training (HIIT) for patients with chronic diseases. J Sport Health Sci 5(2):139–144. https://doi.org/10.1016/j.jshs.2016.04.005

    Article  PubMed  PubMed Central  Google Scholar 

  19. Liou K, Ho S, Fildes J et al (2016) High intensity interval versus moderate intensity continuous training in patients with coronary artery disease: a meta-analysis of physiological and clinical parameters. Heart Lung Circ 25(2):166–174. https://doi.org/10.1016/j.hlc.2015.06.828

    Article  PubMed  Google Scholar 

  20. Polman CH, Reingold SC, Banwell B et al (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69(2):292–302. https://doi.org/10.1002/ana.22366

    Article  PubMed  PubMed Central  Google Scholar 

  21. Fletcher GF, Balady GJ, Amsterdam EA et al (2001) Exercise standards for testing and training: a statement for healthcare professionals From the American Heart Association. Circulation 104(14):1694–1740. https://doi.org/10.1161/hc3901.095960

    Article  CAS  PubMed  Google Scholar 

  22. Appell H-J (2002) Lehrbuch der Sportmedizin, Unveränd. Nachdr. Dt. Ärzte-Verl., Köln

    Google Scholar 

  23. Wonisch M, Hofmann P, Pokan R et al (2003) Spiroergometrie in der Kardiologie—Grundlagen der Physiologie und Terminologie. Journal für Kardiologie 10(9):383–390

    Google Scholar 

  24. Krupp LB, LaRocca NG, Muir-Nash J et al (1989) The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10):1121–1123

    Article  CAS  PubMed  Google Scholar 

  25. Whitehead L (2009) The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures. J Pain Symptom Manage 37(1):107–128. https://doi.org/10.1016/j.jpainsymman.2007.08.019

    Article  PubMed  Google Scholar 

  26. Polman CH, Rudick RA (2010) The multiple sclerosis functional composite: a clinically meaningful measure of disability. Neurology 74 (Suppl 3):S8–S15. https://doi.org/10.1212/WNL.0b013e3181dbb571

    Article  PubMed  Google Scholar 

  27. Motl RW, Cohen JA, Benedict R et al (2017) Validity of the timed 25-foot walk as an ambulatory performance outcome measure for multiple sclerosis. Mult Scler 23(5):704–710. https://doi.org/10.1177/1352458517690823

    Article  PubMed  PubMed Central  Google Scholar 

  28. Lerdal A, Wahl A, Rustøen T et al (2005) Fatigue in the general population: A translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale. Scand J Public Health 33(2):123–130. https://doi.org/10.1080/14034940410028406

    Article  PubMed  Google Scholar 

  29. Rosti-Otajärvi E, Hämäläinen P, Wiksten A et al (2017) Validity and reliability of the fatigue severity scale in finnish multiple sclerosis patients. Brain Behav 7(7):e00743. https://doi.org/10.1002/brb3.743

    Article  PubMed  PubMed Central  Google Scholar 

  30. Bühner M, Ziegler M (2009) Statistik für Psychologen und Sozialwissenschaftler. Pearson Studium, München

    Google Scholar 

  31. Rost R (2005) Sport- und Bewegungstherapie bei Inneren Krankheiten: Lehrbuch für Sportlehrer, Übungsleiter, Physiotherapeuten und Sportmediziner, 3. Aufl. komplett überarb. und erw. von B. Bjarnason-Wehrens (and others). Deutscher Ärzte-Verlag, Köln

  32. Weston KS, Wisloff U, Coombes JS (2014) High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med 48(16):1227–1234. https://doi.org/10.1136/bjsports-2013-092576

    Article  PubMed  Google Scholar 

  33. Koufaki P, Mercer TH, George KP et al (2014) Low-volume high-intensity interval training vs continuous aerobic cycling in patients with chronic heart failure: a pragmatic randomised clinical trial of feasibility and effectiveness. J Rehabil Med 46(4):348–356. https://doi.org/10.2340/16501977-1278

    Article  PubMed  Google Scholar 

  34. Langeskov-Christensen M, Heine M, Kwakkel G et al (2015) Aerobic capacity in persons with multiple sclerosis: a systematic review and meta-analysis. Sports Med 45(6):905–923. https://doi.org/10.1007/s40279-015-0307-x

    Article  PubMed  Google Scholar 

  35. Wonneberger M, Schmidt S (2015) Changes of gait parameters following long-term aerobic endurance exercise in mildly disabled multiple sclerosis patients: an exploratory study. Eur J Phys Rehabil Med 51(6):755–762

    CAS  PubMed  Google Scholar 

  36. Kodama S, Saito K, Tanaka S et al (2009) Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA 301(19):2024–2035. https://doi.org/10.1001/jama.2009.681

    Article  CAS  PubMed  Google Scholar 

  37. Marrie R, Horwitz R, Cutter G et al (2009) High frequency of adverse health behaviors in multiple sclerosis. Mult Scler 15(1):105–113. https://doi.org/10.1177/1352458508096680

    Article  PubMed  Google Scholar 

  38. Marrie R, Horwitz R, Cutter G et al (2008) Comorbidity, socioeconomic status and multiple sclerosis. Mult Scler 14(8):1091–1098. https://doi.org/10.1177/1352458508092263

    Article  PubMed  Google Scholar 

  39. Heine M, Wens I, Langeskov-Christensen M et al (2016) Cardiopulmonary fitness is related to disease severity in multiple sclerosis. Mult Scler 22(2):231–238. https://doi.org/10.1177/1352458515581437

    Article  PubMed  Google Scholar 

  40. Andreasen A, Stenager E, Dalgas U (2011) The effect of exercise therapy on fatigue in multiple sclerosis. Mult Scler J 17(9):1041–1054. https://doi.org/10.1177/1352458511401120

    Article  CAS  Google Scholar 

  41. Heine M, Verschuren O, Hoogervorst ELJ et al (2017) Does aerobic training alleviate fatigue and improve societal participation in patients with multiple sclerosis? A randomized controlled trial. Mult Scler 23(11):1517–1526. https://doi.org/10.1177/1352458517696596

    Article  PubMed  PubMed Central  Google Scholar 

  42. Heine M, van de Port I, Rietberg MB et al (2015) Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst Rev 9:CD009956. https://doi.org/10.1002/14651858.CD009956.pub2

    Article  Google Scholar 

  43. Langeskov-Christensen M, Bisson EJ, Finlayson ML et al (2017) Potential pathophysiological pathways that can explain the positive effects of exercise on fatigue in multiple sclerosis: A scoping review. J Neurol Sci 373:307–320. https://doi.org/10.1016/j.jns.2017.01.002

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Not applicable.

Funding

This study was supported by a research grant from Bayer Vital (Grant PB05). The sponsor has neither taken influence on the preparation of the article nor on the collection, analysis, and interpretation of data.

Author information

Authors and Affiliations

  1. Schule für Physiotherapie Gummersbach-DAA Gesundheit und Soziales, Becketalstraße 1-3, 51643, Gummersbach, Germany

    Marc Wonneberger

  2. Neurologische Gemeinschaftspraxis Bonn, Gesundheitszentrum St. Johannes, Kölnstr. 54, 53111, Bonn, Germany

    Stephan Schmidt

  3. Department of Neurology, Ruhr-University of Bochum, Knappschafts-Krankenhaus Langendreer, An der Schornau 23-25, 44892, Bochum, Germany

    Stephan Schmidt

Authors
  1. Marc Wonneberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephan Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephan Schmidt.

Ethics declarations

Conflict of interests

Both authors have received compensations from Bayer Vital for lecturing. S.Schmidt has also served on advisory boards for Bayer Vital.

Ethical approval

All procedures were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of Deutsche Sporthochschule, Cologne, Germany.

Informed consent

All participants gave written informed consent prior to study participation.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wonneberger, M., Schmidt, S. High-intensity interval ergometer training improves aerobic capacity and fatigue in patients with multiple sclerosis. Sport Sci Health 15, 559–567 (2019). https://doi.org/10.1007/s11332-019-00545-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11332-019-00545-1

Search

Navigation