High-intensity resistance training in multiple sclerosis - An exploratory study of effects on immune markers in blood and cerebrospinal fluid, and on mood, fatigue, health-related quality of life, muscle strength, walking and cognition

Marie Kierkegaard; Ingrid E Lundberg; Tomas Olsson; Sverker Johansson; Sofia Ygberg; Christina Opava; Lotta Widén Holmqvist; Fredrik Piehl

doi:10.1016/j.jns.2016.01.063

High-intensity resistance training in multiple sclerosis - An exploratory study of effects on immune markers in blood and cerebrospinal fluid, and on mood, fatigue, health-related quality of life, muscle strength, walking and cognition

J Neurol Sci. 2016 Mar 15:362:251-7. doi: 10.1016/j.jns.2016.01.063. Epub 2016 Feb 3.

Authors

Marie Kierkegaard¹, Ingrid E Lundberg², Tomas Olsson³, Sverker Johansson⁴, Sofia Ygberg⁵, Christina Opava⁶, Lotta Widén Holmqvist⁷, Fredrik Piehl⁸

Affiliations

¹ Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23 100, S-141 83 Huddinge, Sweden; Department of Physiotherapy, A6:U1, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Marie.Kierkegaard@ki.se.
² Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Solna, Karolinska Institutet, S-171 76, Stockholm, Sweden. Electronic address: Ingrid.Lundberg@ki.se.
³ Department of Clinical Neurosciences, K8, Karolinska Institutet, CMM L8:04, S-171 76 Stockholm, Sweden; Department of Neurology, R3:04, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Tomas.Olsson@ki.se.
⁴ Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23 100, S-141 83 Huddinge, Sweden; Department of Physiotherapy, A6:U1, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Sverker.Johansson@ki.se.
⁵ Department of Women's and Children's Health, Karolinska Institutet, Elevhemmet H2:00, Karolinska University Hospital, S171 76 Stockholm, Sweden. Electronic address: Sofia.Ygberg@karolinska.se.
⁶ Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23 100, S-141 83 Huddinge, Sweden; Department of Rheumatology, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Christina.Opava@ki.se.
⁷ Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23 100, S-141 83 Huddinge, Sweden; Department of Physiotherapy, A6:U1, Karolinska University Hospital, S-171 76 Stockholm, Sweden; Department of Clinical Neurosciences, Division of Neurology, Karolinska Institutet, R54 Karolinska University Hospital, S-141 86 Stockholm, Sweden. Electronic address: Lotta.Holmqvist@ki.se.
⁸ Department of Clinical Neurosciences, K8, Karolinska Institutet, CMM L8:04, S-171 76 Stockholm, Sweden; Department of Neurology, R3:04, Karolinska University Hospital, S-171 76 Stockholm, Sweden. Electronic address: Fredrik.Piehl@ki.se.

PMID: 26944158
DOI: 10.1016/j.jns.2016.01.063

Abstract

Background: High-intensity resistance training is unexplored in people with multiple sclerosis.

Objectives: To evaluate effects of high-intensity resistance training on immune markers and on measures of mood, fatigue, health-related quality of life, muscle strength, walking and cognition. Further, to describe participants' opinion and perceived changes of the training.

Methods: Twenty patients with relapsing-remitting multiple sclerosis performed high-intensity resistance training at an intensity of 80% of one-repetition maximum, twice a week for 12 weeks. Blood and optional cerebrospinal fluid samples, and data on secondary outcome measures were collected before and after intervention. A study-specific questionnaire was used for capturing participants' opinion.

Results: Seventeen participants completed the study. Plasma cytokine levels of tumor necrosis factor were significantly decreased post-intervention (p=0.001). Exploratory cytokine analyses in cerebrospinal fluid (n=8) did not reveal major changes. Significant and clinically important improvements were found in fatigue (p=0.001) and health-related quality of life (p=0.004). Measures of mood (p=0.002), muscle strength (p ≤ 0.001), walking speed (p=0.013) and cognition (p=0.04) were also improved. A majority of participants evaluated the training as very good and perceived changes to the better.

Conclusion: High-intensity resistance training in persons with relapsing remitting multiple sclerosis with low disability had positive effects on peripheral pro-inflammatory cytokine levels, led to clinically relevant improvements in measures of fatigue and health-related quality of life, and was well tolerated. These results provide a basis for a larger randomized trial.

Keywords: Exercise; Fatigue; Immunology; Multiple sclerosis; Quality of life; Resistance training.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Cognition Disorders / etiology*
Cognition Disorders / rehabilitation
Cytokines / blood*
Cytokines / cerebrospinal fluid*
Fatigue / etiology*
Female
Humans
Male
Middle Aged
Mood Disorders / etiology*
Multiple Sclerosis, Relapsing-Remitting* / metabolism
Multiple Sclerosis, Relapsing-Remitting* / psychology
Multiple Sclerosis, Relapsing-Remitting* / rehabilitation
Muscle Strength / physiology*
Neuropsychological Tests
Quality of Life / psychology*
Resistance Training*
Retrospective Studies
Young Adult

Substances

Cytokines