Optimization of the Exercise Stimulus by Pre-Cooling in Multiple Sclerosis.

TitleOptimization of the Exercise Stimulus by Pre-Cooling in Multiple Sclerosis.
Publication TypeJournal Article
AuthorsAlquist AD, Kraft GH
JournalInternational Journal of MS Care

Heat sensitivity, fatigue, weakness, and lessened coordination are primary symptoms among multiple sclerosis (MS) persons which lead to increased disability and decreased motor function. Our recent pilot investigations support that both acute body cooling and progressive resistance exercise (PRE) training can independently improve motor function and lessen reported disability among heat sensitive MS patients. We hypothesize that body cooling immediately prior to PRE training will increase the capacity to perform coordinated PRE training movements and provide a greater chronic exercise stimulus to gain strength, coordination, and endurance and lessen fatigue and depression than cooling or PRE dosed separately. To test the above hypotheses a double blind, treatment-controlled, 2 X 2 randomized block design was employed. The subjects were randomized to cool at either 7.2ºC (active cooling; AC) or 26.7ºC (sham cooling; SC) and exercise at either high-dose PRE (HPRE) or low-dose PRE (LPRE; {sub-training threshold}). Thirty-two MS subject will be assigned into one of four groups. Eight subjects have completed the training. Subjects trained three sessions each week for 12 consecutive weeks. Primary outcome measures were assessed before and after the 12-week training. The outcome measures consisted of: strength, systemic endurance, self-selected ambulation velocity, and depression scale (CES-D). Preliminary Results (data from eight subjects [2/groups] have been averaged): Mean Change Scores (before and after 12 weeks of training) Positive Values are Improvement, Negative Values are Worsening Group Endurance Strength Walking Depression (sec) (ft-lbs) (m/min) (index) AC-HPRE 47 20 12.3 11 AC-LPRE -21 5 -4.9 3 SC-HPRE 26 9 0.9 6 SC-LPRE -18 -2 -0.6 1 Conclusion: The subjects that were actively cooled prior to high-dose progressive resistance training made the greatest gains in endurance, strength, ambulation, and depression. The preliminary data support the hypothesis that cooling prior to exercise optimizes the exercise stimulus versus exercise or cooling alone.


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