Effect of eight weeks respiratory muscle training on respiratory capacity, functional capacity and quality of life on subjects with mild to moderate relapsing-remitting multiple sclerosis: A single-blinded randomized controlled trial.

BACKGROUND: Multiple Sclerosis (MS) is a chronic inflammatory disease of the nervous system leading to muscle weakness, including the respiratory muscles that cause pulmonary complications, impair functional capacity, increased fatigue, and as a result decreases the quality of life. AIM: The purpose of the present study is to examine the influence of 8 weeks of respiratory muscle training (RMT) on pulmonary function and respiratory muscle strength in MS patients. METHODS: The present study was a single-blind, randomized controlled trial that was conducted on 36 (27 Female, 9 Male) relapsing-remitting MS patients who were definitively diagnosed by a neurologist and randomly were divided into intervention and control groups. Both groups were educated on lifestyle modification with an emphasis on regular physical activity. In addition, the intervention group was prescribed eight weeks of respiratory muscle training with a threshold resistance device, daily, twice a day for three sets of 15 repetitions per set. Maximal expiratory pressure (PImax), maximal expiratory pressure (PEmax), spirometric indices, functional tests (six-minute walk test, timed up and go test), fatigue questionnaire, and questionnaire of quality of life were assessed before and after trials. RESULTS: A total of 36 patients (75% female; mean age 38.00(8.86) years; BMI 26.56(2.64) kg/m2) were included in the study. The strength of inspiratory and expiratory muscles, respiratory function, fatigue, and quality of life were significantly improved in the intervention group (p<0.005). In addition, there was a significant improvement in the rate of fatigue and quality of life in all their dimensions (p<0.005). Only in the six-minute walk test, no significant improvement was seen in the intervention group compared to the control group (p = 0.262). CONCLUSION: Findings could help therapists to provide MS patients with more effective respiratory muscle training protocols to maximize the benefits of rehabilitation.

Effect of endurance training on cardiopulmonary fitness in people with multiple sclerosis.

INTRODUCTION: Disturbances associated with Multiple Sclerosis (MS) can be due to the pathologic process of the disease or insufficient physical fitness. The benefits of exercise in improving cardiopulmonary fitness have been demonstrated in animal studies and also clinical trials on cardiovascular patients and healthy human cases; however, its effectiveness in people with MS(pwMS) is still unknown. people with MS often engage in rehabilitation programs for exercise tolerance improvement. Therefore, it is necessary to investigate the effect of this specific intervention on cardiopulmonary fitness of these patients. The present study intended to illustrate the etiology of exercise intolerance in pwMS and also the effects of exercise on these etiological factors. METHODS AND RESULTS: The present interventional study included 21 female patients suffering from Relapsing-Remitting MS (RR-MS) who had a mean age of 35 ± 5.18 years and the Expanded Disability Status Scale (EDSS) scores of 1 to 4. All the participants underwent Cardiopulmonary Exercise Testing (CPET) on an ergometer pre- and post-intervention. The intervention included 18 sessions of endurance training using a stationary bicycle with an intensity of 70% of the peak Heart Rate (HR) or 60% of the peak VO2 (Volume of oxygen consumption) under the supervision and cardiac monitoring. A total of 24 variables, including the parameters cardiopulmonary fitness (aerobic fitness), were investigated. Also, all the maximal variables were analyzed in the same RER(Respiratory Exchange Ration) (a mean RER of 0.92) pre- and post-intervention. According to the results, a total of 17 variables out of 24 study variables had significant changes (P < 0.05). CONCLUSION: The present study showed that even a short, 6-week course of aerobic exercise could change the peak HR and VO2, improving the cardio pulmonary fitness in these patients. This indicates the adaptation of the cardiopulmonary system to exercise in pwMS. In other words, these cardiopulmonary fitness variables improvement due to exercise demonstrates that this pathology is not merely caused by the MS-induced Central Nervous System (CNS) involvement and can be improved by improving cardiopulmonary fitness.