多发性硬化症的分期运动疗法与传统运动疗法：一项随机对照试验。

Periodized versus classic exercise therapy in Multiple Sclerosis: a randomized controlled trial.

作者信息

Keytsman Charly, Van Noten Pieter, Verboven Kenneth, Van Asch Paul, Eijnde Bert O

机构信息

REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium; BIOMED Biomedical Research Institute, Hasselt University, Agoralaan Building A, B-3590, Diepenbeek, Belgium.

出版信息

Mult Scler Relat Disord. 2021 Apr;49:102782. doi: 10.1016/j.msard.2021.102782. Epub 2021 Jan 20.

DOI:10.1016/j.msard.2021.102782

PMID:33503527

Abstract

BACKGROUND

Periodizing exercise interventions in Multiple Sclerosis (MS) shows good high intensity exercise training adherence. Whether this approach induces comparable training adaptations with respect to exercise capacity, body composition and muscle strength compared to conventional, linear progressive training programs however is not known.

METHODS

Thirty-one persons with MS (all phenotypes, mean EDSS 2.3±1.3) were randomized into a twelve-week periodized (MS, n=17) or a classic endurance (MS, n=14) training program. At baseline (PRE), exercise capacity (maximal exercise test, VO), body composition (DEXA) and muscle strength (Biodex®) were assessed. Classic, moderate intensity endurance training (60-80% HR, 5 training sessions/2w, 60min/session) was performed on a stationary bicycle. Periodized exercise included 4 recurrent 3-week cycles of alternated endurance training (week 1: endurance training as described above), high intense exercise (week 2: 3 sessions/w, 3 × 20s all-out sprints, 10min/session) and recovery weeks (week 3: one sprint session as described above). POST measurements were performed similar to baseline. Total exercise volume of both programs was expressed as total peak-effort training minutes.

RESULTS

For MS, total exercise volume included 1728 total peak-effort training minutes, whereas MS included only 736. Despite this substantially reduced training volume, twelve weeks of periodized training significantly (p<0.05) improved VO (+14%, p=0.001), workload (+20%) and time until exhaustion (+25%). Classic training significantly (p<0.05) improved workload (+10%) and time until exhaustion (+17%), but not VO (+5%, p=0.131). Pre-post improvements for VO were significantly higher in MS compared to MS (p=0.046).

CONCLUSION

These data show that despite substantially lower training time (57% less peak-effort training minutes), 12 weeks of periodized exercise training in persons with MS seems to induce larger improvements in parameters of exercise capacity compared to classic endurance training. We therefore recommend to further investigate the effect of training periodization on various functional rehabilitation measures in MS.

摘要

背景

对多发性硬化症（MS）患者的运动干预进行阶段性划分显示出较高的高强度运动训练依从性。然而，与传统的线性渐进训练计划相比，这种方法在运动能力、身体成分和肌肉力量方面是否能引发类似的训练适应性尚不清楚。

方法

31例MS患者（所有表型，平均扩展残疾状态量表[EDSS]为2.3±1.3）被随机分为为期12周的阶段性训练组（MS组，n = 17）或经典耐力训练组（MS组，n = 14）。在基线期（PRE），评估运动能力（最大运动测试，VO）、身体成分（双能X线吸收法[DEXA]）和肌肉力量（Biodex®）。经典的中等强度耐力训练（心率60 - 80%，每2周训练5次，每次60分钟）在固定自行车上进行。阶段性运动包括4个重复的3周周期，交替进行耐力训练（第1周：如上所述的耐力训练）、高强度运动（第2周：每周3次，每次3×20秒全力冲刺，每次10分钟）和恢复周（第3周：如上所述的一次冲刺训练）。POST测量与基线期类似。两个训练计划的总运动量均以总峰值努力训练分钟数表示。

结果

对于MS组，总运动量包括1728总峰值努力训练分钟，而MS组仅为736分钟。尽管训练量大幅减少，但12周的阶段性训练显著（p<0.05）提高了VO（+14%，p = 0.001）、工作量（+20%）和直至疲劳的时间（+25%）。经典训练显著（p<0.05）提高了工作量（+10%）和直至疲劳的时间（+17%），但VO未显著提高（+5%，p = 0.131）。与MS组相比，MS组VO的前后改善显著更高（p = 0.046）。