Efficacy of high-intensity aerobic exercise on brain MRI measures in multiple sclerosis

Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011241
Author(s):  
Martin Langeskov-Christensen ◽  
Lars Grøndahl Hvid ◽  
Mikkel Karl Emil Nygaard ◽  
Steffen Ringgaard ◽  
Henrik Boye Jensen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Aerobic Exercise ◽  
Cardiorespiratory Fitness ◽  
Relapse Rate ◽  
High Intensity ◽  
Brain Mri ◽  
Exercise Group ◽  
Link Type ◽  
Significant Difference ◽  
Disease Modifying

ObjectiveTo determine whether 24 weeks of high-intensity progressive aerobic exercise (PAE) affects brain MRI measures in people with multiple sclerosis (MS).MethodsWe conducted a randomized, controlled, phase 2 trial (with a crossover follow-up) including an exercise group (supervised PAE followed by self-guided physical activity) and a waitlist group (habitual lifestyle followed by supervised PAE). Mildly to severely impaired MS patients aged 18–65 years were randomized (1:1). The primary outcome was percentage brain volume change (PBVC) after 24 weeks, analyzed using the intention-to-treat principle.ResultsEighty-six participants were recruited. PBVC did not change over the intervention period (mean between-group change +0.12%, 95% CI −0.27 to 0.51, p = 0.55). In contrast, cardiorespiratory fitness (+3.5 mL O2/min/kg, 2.0 to 5.1, p < 0.01) and annualized relapse rate (0.00, 0.00–0.07 vs +0.45, 0.28 to 0.61, p < 0.01) improved in the exercise group.ConclusionThese findings do not support a neuroprotective effect of PAE in terms of total brain atrophy in people with MS and it did not lead to a statistically significant difference in gray matter parenchymal fraction. PAE led to improvements in cardiorespiratory fitness and a lower relapse rate. While these exploratory findings cautiously support PAE as a potential adjunct disease-modifying treatment in MS, further investigations are warranted.Clinicaltrials registrationClinicalTrials.gov identifier NCT02661555.Classification of evidenceThis study provides level I evidence that 24 weeks of high-intensity PAE did not elicit disease-modifying effects in PBVC in people with MS. Exploratory analyses showed that PAE may reduce relapse rate.

Six-month outcomes of a high intensity exercise programme in young patients with hypertrophic cardiomyopathy: The SAFE-HCM trial

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Basu ◽  
S Jayakumar ◽  
C Miles ◽  
G Parry-Williams ◽  
H Maclachlan ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
High Intensity ◽  
Young Patients ◽  
Exercise Adherence ◽  
Exercise Programme ◽  
Exercise Group ◽  
Moderate Intensity ◽  
Psychological Benefits ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Cardiac Risk in the Young Background Moderate intensity exercise training in older patients with hypertrophic cardiomyopathy (HCM) can improve functional capacity, without significant harm. However, younger patients are attracted to high intensity training (HIT) regimes. The SAFE-HCM study demonstrated that an individually tailored, HIT programme in young patients with HCM was feasible, and provided both health and psychological benefits, without an increase in the burden of arrhythmia. Purpose To assess whether observed benefits of a HIT programme in young patients with HCM are sustained at 6 months. Methods Eighty patients with HCM (45.7y+/-8.6) underwent baseline clinical and psychological assessment. Individuals were randomised to a 12-week HIT programme (n = 40) or usual care (n = 40). Baseline evaluation was repeated at 12 weeks (T12). Feasibility, safety, health and psychological benefits were assessed. At 12-weeks individuals were encouraged to continue with the frequency and intensity of physical activity (PA) achieved at the end of the cardiac rehabilitation programme. Participants in the exercise arm were invited to follow-up at 6 months (T6m). Results The majority (83%) of participants completed the 12-week study. At T12 there was no significant difference between groups in the composite arrhythmia safety outcome (p = 0.99). The indices of exercise capacity were significantly improved in the exercise compared to the control group; peak VO2 (+3.7ml/kg/min [CI 1.1,6.3], p = 0.006), VO2/kg at anaerobic threshold (VO2/kgAT) (+2.44ml/kg/min [CI 0.6,4.2], p = 0.009), time to AT (+115s [CI 54.3,175.9], p &lt; 0.001) and exercise time (max ET) (+108s [CI 33.7,182.2], p = 0.005). The exercise group also demonstrated greater reduction in systolic BP (-7.3mmHg [CI -11.7,-2.8], p = 0.002), BMI (-0.8kg/m2 [CI-1.1,-0.4], p &lt; 0.001), anxiety (-2.6 [CI-3.6,-1.6], p= &lt;0.001) and depression (-1.1 [CI -2.0,-0.2], p = 0.015) scores. At T6m patient reported exercise adherence was comparable to baseline PA in 33/34 of the exercise group attending for follow up. Most exercise gains dissipated with the exception of time to AT (p = 0.002), max ET (p = 0.003), VO2/kgAT (p = 0.04) and anxiety score (p &lt; 0.001) (Figure 1). There were no sustained episodes of atrial or ventricular arrhythmias. The incidence of NSVT did not differ between time points (p = 0.09). Conclusion A 12-week HIT programme in young patients with HCM offers considerable gains in fitness and psychological outcomes, with no increase in arrhythmic burden. At T6m exercise levels as well as most physiological adaptations and health benefits returned to baseline, as seen in other studies when formal participation in an exercise programme comes to an end. This highlights the importance of the implementation of strategies to encourage ongoing engagement in PA. Potential solutions include identification of barriers to exercise, as well as adoption of novel tele-rehabilation approaches. Abstract Figure 1 Sustained benefits at T6m

scholarly journals Brain Structure, Cardiorespiratory Fitness, and Executive Control Changes after a 9-Week Exercise Intervention in Young Adults: A Randomized Controlled Trial

Life ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 292
Author(s):  
Lina Zhu ◽  
Qian Yu ◽  
Fabian Herold ◽  
Boris Cheval ◽  
Xiaoxiao Dong ◽  
...  
Keyword(s):  
Young Adults ◽  
Aerobic Exercise ◽  
Cardiorespiratory Fitness ◽  
Executive Control ◽  
Brain Structure ◽  
Grey Matter ◽  
Exercise Intervention ◽  
Exercise Group ◽  
Control Group ◽  
Younger Adults

Cardiorespiratory fitness (CRF) is assumed to exert beneficial effects on brain structure and executive control (EC) performance. However, empirical evidence of exercise-induced cognitive enhancement is not conclusive, and the role of CRF in younger adults is not fully understood. Here, we conducted a study in which healthy young adults took part in a moderate aerobic exercise intervention program for 9 weeks (exercise group; n = 48), or control condition of non-aerobic exercise intervention (waitlist control group; n = 72). Before and after the intervention period maximal oxygen uptake (VO2max) as an indicator of CRF, the Flanker task as a measure of EC performance and grey matter volume (GMV), as well as cortical thickness via structural magnetic resonance imaging (MRI), were assessed. Compared to the control group, the CRF (heart rate, p < 0.001; VO2max, p < 0.001) and EC performance (congruent and incongruent reaction time, p = 0.011, p < 0.001) of the exercise group were significantly improved after the 9-week aerobic exercise intervention. Furthermore, GMV changes in the left medial frontal gyrus increased in the exercise group, whereas they were significantly reduced in the control group. Likewise, analysis of cortical morphology revealed that the left lateral occipital cortex (LOC.L) and the left precuneus (PCUN.L) thickness were considerably increased in the exercise group, which was not observed in the control group. The exploration analysis confirmed that CRF improvements are linked to EC improvement and frontal grey matter changes. In summary, our results support the idea that regular endurance exercises are an important determinant for brain health and cognitive performance even in a cohort of younger adults.

Biochemical Markers of Ovarian Reserve in Females, Effect of Exercise on Such Reserves

2021 ◽  
Vol 15 (8) ◽  
pp. 2260-2262
Author(s):  
Ayesha Zubair ◽  
Anas Khalil ◽  
Hassan Jamil ◽  
Anam Rehman ◽  
Bashir Ahmed Shaheen ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Aerobic Exercise ◽  
Ovarian Reserve ◽  
Biochemical Markers ◽  
Exercise Group ◽  
Slight Reduction ◽  
Heavy Exercise ◽  
Exercise Tests ◽  
Significant Difference ◽  
Sedentary Life

Background: Female who are in fertile period of their life and prefer a sedentary life style rather than performing regular physical exercise, whether light or heavy exercise show different hormonal pattern which effect their physical health. Such hormonal changes are directly related to the level of ovarian reserve of hormones which are negatively affected by lack of exercise. The ovarian pool of hormones decline with age and also lack of physical exercise. Among the large pool of biochemical markers AMH (anti-mullerian hormone) appears to be the most important and helpful indicator of ovarian reserve. Inclusion criteria: Healthy females between 25 to 35 years of age were included in the study. Exclusion criteria: Females below 25 years and above 35 years of age were excluded from the study, in addition those females having some medical problem or using some medication were also excluded from the study. Material and Methods: 20 females consented to participate in the study who were divided in two groups. These females were living a sedentary life before they joined the gymnasium. One group was subjected to light aerobic exercise and other group to heavy physical exercise. Tests before the start of study were conducted and were repeated after 08 weeks of study to observe the effect of both exercises on the ovarian reserves of different hormones. Results: The comparison between both groups were observed, the values before and after exercise has a remarkable difference, a decrease in values were observed in body weight, BMI, waist and hip ratio after exercise. Slight reduction in E2 and FSH level after aerobic exercises was observed. Whereas in heavy exercise group significant difference i.e. increase in level of FSH was observed at the same time, significant decrease in AMH level was also observed. The difference between E2 and LH had no significance in heavy exercise group. Conclusion: Those females who were living sedentary life and performed light aerobic exercise, even for a longer time period did not showed significant change in the E2, LH, FSH and AMH level of hormones. However, heavy exercise reduces the level of AMH and increases the level of FSH. These finding suggest heavy exercise may affect fertility in a negative way especially in females with low ovarian reserves. Keywords: Exercise, spinning, ovarian reserve, AMHh anti-mullerian hormone

High-intensity interval exercise improves cognitive performance and reduces matrix metalloproteinases-2 serum levels in persons with multiple sclerosis: A randomized controlled trial

2017 ◽  
Vol 24 (12) ◽  
pp. 1635-1644 ◽  
Author(s):  
Philipp Zimmer ◽  
Wilhelm Bloch ◽  
Alexander Schenk ◽  
Max Oberste ◽  
Stefan Riedel ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Matrix Metalloproteinases ◽  
Aerobic Exercise ◽  
Cognitive Performance ◽  
Verbal Memory ◽  
High Intensity ◽  
Controlled Trial ◽  
Exercise Programme ◽  
Healthy Elderly ◽  
The Impact

Background: Aerobic exercise can improve cognitive performance in healthy elderly people. Objective: The aim of this study was to investigate the influence of a 3-week high-intensity aerobic exercise programme (high-intensity training group (HIT)) on cognitive performance in persons with multiple sclerosis (MS) compared with a standard exercise programme (control training (CT)). Methods: A total of 60 persons with MS (Expanded Disability Status Scale (EDSS): 1.0–6.5) were randomized to a HIT group (3×/week for 20 minutes, including five 3-minute exercise intervals at 80% of peak oxygen uptake (VO2-peak)) or a CT group (continuously 5×/week for 30 minutes/session at 65% of VO2-peak). Cognitive performance was assessed using the Brief International Cognitive Assessment for MS at entry ( t0) and discharge ( t1). Furthermore, VO2-peak, brain-derived neurotrophic factor, serotonin and matrix metalloproteinases (MMP)-2 and -9 were measured. Results: Compared to CT, HIT significantly improved verbal memory. Significant improvements over time in executive functions were found in both groups. Secondary outcomes indicated significant improvements in VO2-peak and a significant reduction in MMP-2 in the HIT group only. Conclusion: HIT represents a promising strategy to improve verbal memory and physical fitness in persons with MS. Further research is needed to determine the impact of exercise on biomarkers in MS.

scholarly journals High-intensity exercise to promote accelerated improvements in cardiorespiratory fitness (HI-PACE): Study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Joshua E. McGee ◽  
Savanna G. Barefoot ◽  
Nicole R. Gniewek ◽  
Patricia M. Brophy ◽  
Angela Clark ◽  
...  
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
African Americans ◽  
Aerobic Exercise ◽  
Cardiorespiratory Fitness ◽  
High Intensity ◽  
Controlled Trial ◽  
High Intensity Exercise ◽  
Moderate Intensity

Abstract Background African Americans have a disproportionate prevalence and incidence of type 2 diabetes compared to Caucasians. Recent evidence indicates low cardiorespiratory fitness (CRF) level, an independent risk factor for type 2 diabetes, is also more prevalent in African Americans than Caucasians. Numerous studies in Caucasian populations suggest vigorous exercise intensity may promote greater improvements in CRF and other type 2 diabetes risk factors (e.g. reduction of glucose/insulin levels, pulse wave velocity, body fat, etc.) than moderate intensity. However, current evidence comparing health benefits of different aerobic exercise intensities on type 2 diabetes risk factors in African Americans is negligible. This is clinically important as African Americans have a greater risk for type 2 diabetes and are less likely to meet public health recommendations for physical activity than Caucasians. The purpose of the High-Intensity exercise to Promote Accelerated improvements in CardiorEspiratory fitness (HI-PACE) study is to evaluate whether high-intensity aerobic exercise elicits greater improvements in CRF, insulin action, and arterial stiffness than moderate-intensity exercise in African Americans. Methods/Design­ A randomized controlled trial will be performed on overweight and obese (body mass index: 25-45 kg/m2) African Americans (35-65 years) (n=60). Participants will be randomized to moderate-intensity (MOD-INT) or high-intensity (HIGH-INT) aerobic exercise training, or a non-exercise control group (CON) for 24 weeks. Supervised exercise will be performed at a heart rate associated with 45-55% and 70-80% of VO2 max in the MOD-INT and the HIGH-INT groups, respectively, for an exercise dose of 600 MET-minutes/week (consistent with public health recommendations). The primary outcome is change in CRF. Secondary outcomes include change in insulin sensitivity (measured via an intravenous glucose tolerance test), skeletal muscle mitochondrial oxidative capacity (via near infrared spectroscopy), skeletal muscle measurements (i.e. citrate synthase, COX IV, GLUT-4, CPT-1, PGC1-α), arterial stiffness (via carotid-femoral pulse wave velocity), body fat, C-reactive protein, and psychological outcomes (quality of life/exercise enjoyment). Discussion The anticipated results of the HI-PACE study will provide vital information on the health effects of high-intensity exercise in African Americans. This study will advance health disparity research and has the potential to influence future public health guidelines for physical activity. Trial Registration ClinicalTrials.gov ID: NCT02892331. Registered on 8 September 2016, https://clinicaltrials.gov/ct2/show/NCT02892331

scholarly journals Tick-borne encephalitis vaccination in multiple sclerosis

2020 ◽  
Vol 7 (2) ◽  
pp. e664
Author(s):  
Alexander Winkelmann ◽  
Christoph Metze ◽  
Silvius Frimmel ◽  
Emil C. Reisinger ◽  
Uwe K. Zettl ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Activity ◽  
Geometric Mean ◽  
Expanded Disability Status Scale ◽  
Vaccine Response ◽  
Link Type ◽  
Tick Borne Encephalitis ◽  
Disability Status ◽  
Disease Modifying ◽  
Relapse Rates

ObjectiveTo assess the changes in disease activity after tick-borne encephalitis (TBE) vaccination in patients with multiple sclerosis (MS) on a variety of disease-modifying drugs and to assess the immunogenicity, safety, and clinical tolerability of the vaccine in this patient group.MethodsWe conducted a prospective, multicenter, nonrandomized observational study. We enrolled 20 patients with MS receiving TBE vaccination who had been on disease-modifying treatment (DMT) for at least 6 months. Serum samples were obtained before and after 4 weeks of vaccination to determine the specific TBE antibody response. MS disease activity (Expanded Disability Status Scale and relapse rates) was evaluated for 1 year after immunization. Local and systemic adverse events were registered.ResultsIn 20 subjects with TBE vaccination, the annualized relapse rate decreased from 0.65 in the year before vaccination to 0.21 in the following year. Expanded Disability Status Scale remained stable during the 2-year period before vaccination and 1 year after vaccination (range: 1.50–1.97). The geometric mean titer (GMT) increased from 169 Vienna units per milliliter (VIEU/mL) to 719 VIEU/mL 4 weeks after vaccination (p = 0.001), and 77.8% had protective antibody titers after vaccination. In 9 patients treated with beta interferons, GMT increased from 181 VIEU/mL to 690 VIEU/mL (p = 0.018). Three subjects treated with glatiramer acetate developed a 2- to 9.6-fold increase. Patients treated with fingolimod developed the lowest increase in antibody titer.ConclusionTBE vaccination showed good tolerability and was safe in patients with MS. MS disease activity was not increased, and annualized relapse rates decreased after vaccination. Vaccine response differs according to the underlying DMT.Trial registrationClinicalTrials.gov, clinicaltrials.gov, Identifier: NCT02275741.

scholarly journals Cardiovascular Responses Of Type 2 Diabetes Patients To Intermittent And Continous Aerobic Exercises

2007 ◽  
Author(s):  
Mukadas O Akindele ◽  
Phillip Kodzo ◽  
Mustapha Naimat
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Aerobic Exercise ◽  
Intermittent Exercise ◽  
Cardiovascular Responses ◽  
Exercise Group ◽  
Significant Difference

Background: The use of aerobic exercise as a form of glycemic control in type 2 diabetes mellitus has been well documented in the literatures. High blood pressure has been shown to be one of the sequelae of type 2 diabetes mellitus. Determination of mode of exercises for glycemic control that will not adversely affect the cardiovascular indices of type 2 diabetes mellitus subjects is highly indicated. Objective: The purpose of this study was to determine the acute cardiovascular responses of type 2 diabetes mellitus subjects to continuous and intermittent modes of exercises. Results: There was statistical significant difference in heart rate of both groups. Continuous mode of exercise elicited no statistical difference in SBP and DBP but there was statistical significant difference in SBP in intermittent exercise group with no statistical significant in their DBP. Cross comparison of pre and post cardiovascular indices showed that there were statistical significant differences in SBP (F=0.710, P>0.05) and DBP (F=1.397, P>0.05). Conclusion: Cardiovascular responses of type 2 diabetes mellitus subjects were higher in intermittent exercise group compared with the continuous exercise group. KEYWORDS: Type 2 diabetes mellitus, Aerobic exercise, cardiovascular response.

scholarly journals Effects of different exercise loads on serum betatrophin (ANGPTL-8/lipasin) and cartonectin (CTRP-3) levels in metabolic syndrome

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Muhammed Emre Karaman ◽  
Cengiz Arslan ◽  
Mehmet Ferit Gürsu
Keyword(s):  
Metabolic Syndrome ◽  
Aerobic Exercise ◽  
Tap Water ◽  
Exercise Group ◽  
Anaerobic Exercise ◽  
Male Rats ◽  
Control Group ◽  
Standard Diet ◽  
Positive Effects ◽  
Significant Difference

Abstract Objectives The number of studies examining the circulating level change of betatrophin and cartonectin in metabolic syndrome applying different loads of exercise is limited. The purpose of the present study was to investigate how different loads of exercises regulate the betatrophin and cartonectin levels in metabolic syndrome induced rats. Methods A total of 24 Wistar-Albino male rats were used in the study. Rats were divided into four groups as follows; G1: control group (fed with standard diet and tap water), G2: metabolic syndrome group (without exercise application), G3: metabolic syndrome + aerobic exercise group (aerobic exercise applied), G4: metabolic syndrome + anaerobic exercise group (anaerobic exercise applied). Betatrophin and Cartonectin levels were determined by ELISA method in serum samples. Results There was a statistically significant difference in betatrophin levels between the groups and this differentiation was caused by G2 (p <0.05). Cartonectin levels were not significantly different between groups (p> 0.05). Conclusions It can be concluded that anaerobic exercises have more positive effects on glucose balance in metabolic syndrome than aerobic exercises, and by regulating betatrophin levels, anaerobic exercises indicate this effect.

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