Multiple Sclerosis and Heavy Progressive Resistance Training

Study Overview
=================
Brief Summary
-----------------
The purpose of the present investigation is to determine whether MS patients can tolerate and benefit from heavy progressive resistance training. A second purpose is to determine both neural and muscle morphological adaptations to heavy progressive resistance training.

Detailed Description
-----------------
Multiple sclerosis (MS) patients are characterized by reduced muscle strength and functional capacity. For MS patients, improvements in muscle strength and thereby functional capacity, would have the potential to make both the daily living easier and to extend the time living independently. Attempts to improve muscle strength and function include the application of physical training, although the general advice to MS patients for many years has been to avoid participation in physical training. It has now been demonstrated that endurance training at low to moderate intensity is well tolerated by MS patients, but it only induces modest improvements in both muscle strength and functional capacity. Heavy progressive resistance training (HPRT) has proven to be the most effective means to improve muscle strength and functional capacity during daily activities in healthy older people. However, the effects of HPRT have not been investigated in randomised control trials in MS patients.

Official Title
-----------------
Multiple Sclerosis and Muscle Function - Effects of Heavy Progressive Resistance Training

Conditions
-----------------
Multiple Sclerosis

Intervention / Treatment
-----------------
* Behavioral: Resistance training


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Clinical diagnosis of Relapsing Remitting Multiple Sclerosis according to the McDonald criteria Expanded Disability Status Scale Score between 3,0-5,5 Be able to walk at least 100m Be able to train twice a week at the University Exclusion Criteria: Alcohol abuse, Alzheimer's and pacemaker Comorbidities like cardiovascular-, respiratory-, orthopaedic or metabolic diseases Having had an attack in a period of 8 weeks prior to the start of the intervention period Having an attack during the intervention period Pregnancy Systematic resistance training in a period of 3 months prior to the start of the intervention period. Training adherence of less than 85%.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A<br>12 weeks of resistance training | Behavioral: Resistance training<br>* Intervention group: 12 weeks of resistance training for the lower extremity. Control group: No intervention - 12 weeks of normal daily living<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle strength (isokinetic testing) |  | Before and after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional capacity (Six minute walk test, 10m walk test, chair rise, stair climbing) |  | Before and after the intervention | 
| Muscle biopsies from m. vastus lateralis |  | Before and after the intervention | 
| % Fat (skinfold) |  | Before and after the intervention | 
| Blood samples (immunologic parameters) |  | Before and after the intervention | 
| Fatigue (Fatigue Severity Scale - FSS, Modified Fatigue Inventory - MFI-20) |  | Before and after the intervention | 
| HRQOL: SF36 |  | Before and after the intervention | 
| Depression: Major Depression Inventory (MDI) |  | Before and after the intervention | 
| Surface EMG from m. vastus lateralis during MVC |  | Before and after the intervention | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Resistance training, Strength training, Training adaptations, CNS