Rademacher Annette, Joisten Niklas, Proschinger Sebastian, Bloch Wilhelm, Gonzenbach Roman, Kool Jan, Langdon Dawn, Bansi Jens, Zimmer Philipp
Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany.
Department of "Performance and Health (Sports Medicine)", Institute of Sport and Sport Science, Technical University Dortmund, Dortmund, Germany.
Front Neurol. 2021 Jan 28;11:619500. doi: 10.3389/fneur.2020.619500. eCollection 2020.
Exercise training reveals high potential to beneficially impact cognitive performance in persons with multiple sclerosis (pwMS). Research indicates that high-intensity interval training (HIIT) has potentially higher effects on physical fitness and cognition compared to moderate continuous exercise. This study (i) compares the effects of a 3-week HIIT and moderate continuous exercise training on cognitive performance and cardiorespiratory fitness of pwMS in an overall analysis and (ii) investigates potential effects based on baseline cognitive status in a subgroup analysis. Seventy-five pwMS were randomly assigned to an intervention (HIIT: 5 × 1.5-min intervals at 95-100% HR, 3 ×/week) or active control group (CG: 24 min continuous exercise at 65% HR, 3 ×/week). Cognitive performance was assessed pre- and post-intervention with the Brief International Cognitive Assessment for MS (BICAMS). (I) To examine potential within (time) and interaction (time × group) effects in the overall analysis, separate analyses of covariance (ANCOVA) were conducted. (II) For the subgroup analysis, participants were divided into two groups [intact cognition or impaired cognition (>1.5 standard deviation (SD) compared to healthy, age-matched norm data in at least one of the three tests of the BICAMS]. Potential impacts of cognitive status and intervention were investigated with multivariate analyses of variance (MANOVA). Overall analysis revealed significant time effects for processing speed, verbal learning, rel. VO2peak, and rel. power output. A timegroup interaction effect was observed for rel. power output. Subgroup analysis indicated a significant main effect for cognition (impaired cognition vs. intact cognition). Subsequent analysis showed significant larger effects on verbal learning in pwMS with impaired cognition. Current results need to be confirmed in a powered randomized controlled trial with cognitive performance as primary endpoint and eligibility based on cognitive performance that is assessed prior to study inclusion.
运动训练显示出对改善多发性硬化症患者（pwMS）的认知表现具有巨大潜力。研究表明，与中等强度持续运动相比，高强度间歇训练（HIIT）对身体素质和认知的影响可能更大。本研究（i）在总体分析中比较了为期3周的HIIT和中等强度持续运动训练对pwMS认知表现和心肺适能的影响，以及（ii）在亚组分析中根据基线认知状态调查潜在影响。75名pwMS被随机分配至干预组（HIIT：以心率的95 - 100%进行5次1.5分钟的间歇训练，每周3次）或活性对照组（CG：以心率的65%进行24分钟持续运动，每周3次）。在干预前后使用简易国际多发性硬化症认知评估量表（BICAMS）评估认知表现。（I）为了在总体分析中检验潜在的组内（时间）和交互作用（时间×组）效应，进行了单独的协方差分析（ANCOVA）。（II）对于亚组分析，参与者被分为两组[认知完整或认知受损（与健康、年龄匹配的正常数据相比，在BICAMS的三项测试中至少一项超过1.5个标准差（SD））]。使用多变量方差分析（MANOVA）研究认知状态和干预的潜在影响。总体分析显示，处理速度、言语学习、相对峰值摄氧量和相对功率输出存在显著的时间效应。相对功率输出观察到时间 - 组交互作用效应。亚组分析表明认知存在显著的主效应（认知受损与认知完整）。后续分析显示，认知受损的pwMS在言语学习方面的改善效果显著更大。目前的结果需要在一项以认知表现为主要终点且根据纳入研究前评估的认知表现确定入选标准的有足够样本量的随机对照试验中得到证实。
