Influence of combined functional resistance and endurance exercise over 12 weeks on matrix metalloproteinase-2 serum concentration in persons with relapsing-remitting multiple sclerosis-a community-based randomized controlled trial
Creators: name: Proschinger, Sebastian
name: Joisten, Niklas
name: Rademacher, Annette
name: Schlagheck, Marit L.
name: Walzik, David
name: Metcalfe, Alan J.
name: Oberste, Max
name: Warnke, Clemens
name: Bloch, Wilhelm
name: Schenk, Alexander
name: Bansi, Jens
name: Zimmer, Philipp
Publisher: name: London : BioMed Central Ltd.
Year: 2019
Subjects: subject: Functional exercise
subject: Immune homeostasis
subject: Inflammation
subject: Kynurenine pathway
subject: Matrix metalloproteinase-2
subject: Relapsing-remitting multiple sclerosis
subject: gamma interferon
subject: gelatinase A
subject: gelatinase B
subject: interleukin 10
subject: interleukin 17
subject: interleukin 6
subject: kynurenic acid
subject: kynurenine
subject: nicotinamide adenine dinucleotide
subject: quinolinic acid
subject: tryptophan
subject: tumor necrosis factor
subject: adult
subject: Article
subject: blood brain barrier
subject: blood sampling
subject: cell count
subject: cognition
subject: community sample
subject: controlled study
subject: endurance training
subject: enzyme analysis
subject: enzyme blood level
subject: Expanded Disability Status Scale
subject: gait
subject: human
subject: immunocompetent cell
subject: major clinical study
subject: multiple sclerosis
subject: outcome assessment
subject: patient-reported outcome
subject: physical activity
subject: physical capacity
subject: randomized controlled trial
subject: resistance training
subject: single blind procedure
subject: symptomatology
subject: therapy effect
subject: treatment duration
subject: Dewey Decimal Classification::600 | Technik::610 | Medizin, Gesundheit

description: Background: The relevance of regular moderate to intense exercise for ameliorating psychomotor symptoms in persons with multiple sclerosis (pwMS) is becoming increasingly evident. Over the last two decades, emerging evidence from clinical studies and animal models indicate immune regulatory mechanisms in both periphery and the central nervous system that may underlie these beneficial effects. The integrity of the blood-brain barrier as the main structural interface between periphery and brain seems to play an important role in MS. Reducing the secretion of proteolytic matrix metalloproteinases (MMP), i.e. MMP-2, as disruptors of blood-brain barrier integrity could have profound implications for MS. Methods: In this two-Armed randomized controlled trial 64 participants with relapsing-remitting MS (RRMS) (EDSS 0-4.0) will be allocated to either an intervention group or a passive wait list control group. The intervention group will perform 60 min of combined functional resistance and endurance exercises 3x per week over a period of 12 weeks in a community-based and publicly available setting. Changes in serum concentration of MMP-2 will be the primary outcome. Secondary outcomes are numbers of immune cell subsets, soluble (anti-) inflammatory factors, physical capacity, cognitive performance, physical activity behavior, gait performance, and patient-reported outcomes. All outcome measures will be assessed at baseline and after week 12 with an additional blood sampling before, during and immediately after a single training session in week 6. Discussion: To our knowledge, this will be the first RCT to investigate both the acute and chronic effects of a community-based intense functional resistance and endurance exercise regimen in persons with RRMS. Combining analysis of biological and cognitive or psychological outcomes may provide a better understanding of the MS-specific symptomology. Trial registration: DRKS00017091; 05th of April, 2019; International Clinical Trials Registry Platform.