Englund S, Piehl F, Kierkegaard M
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Academic Specialist Center, Center of Neurology, Stockholm Health Services, SE-113 65 Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Academic Specialist Center, Center of Neurology, Stockholm Health Services, SE-113 65 Stockholm, Sweden.
Mult Scler Relat Disord. 2022 Dec;68:104106. doi: 10.1016/j.msard.2022.104106. Epub 2022 Aug 13.
Exercise studies including only fatigued persons with multiple sclerosis (PwMS) with fatigue as primary endpoint are lacking.
To evaluate the effects of high-intensity resistance training (HIRT) on self-reported fatigue in fatigued PwMS in a single center randomised controlled trial.
We recruited 71 PwMS scoring ≥ 53 on the Fatigue Scale for Motor and Cognitive Functions (FSMC), who were randomised 1:1 to either twice (group A) or once (group B) weekly supervised HIRT for twelve weeks. A non-randomised FSMC score-matched group (n=69) served as non-intervention control.
Between HIRT-group differences were non-significant for primary and most secondary endpoints. Mean difference in FSMC score (95% confidence intervals) was -10.9 (-14.8; -6.9) in group A and -9.8 (-13.2; -6.3) in group B. Corresponding values for combined HIRT groups vs non-intervention control were -10.3 (-12.9; -7.7) and 1.5 (-0.6;3.6), respectively, p<0.001. Secondary endpoints also improved in both HIRT groups, though only Hospital Anxiety and Depression Scale anxiety and MS Impact Scale-29 psychological subscales significantly favoured the twice a week HIRT (group A). As an exploratory endpoint, changes in plasma inflammatory protein markers were associated with reduced FSMC scores in the pooled material.
The finding that HIRT in fatigued PwMS leads to clinically relevant reductions in self-reported fatigue, associated with changes in plasma inflammatory protein levels, provide evidence for recommending HIRT for fatigued PwMS.
缺乏仅以疲劳为主要终点，纳入多发性硬化症疲劳患者（PwMS）的运动研究。
在一项单中心随机对照试验中，评估高强度抗阻训练（HIRT）对疲劳的PwMS患者自我报告的疲劳的影响。
我们招募了71名在运动和认知功能疲劳量表（FSMC）上得分≥53的PwMS患者，将他们按1:1随机分为两组，A组每周接受两次、B组每周接受一次有监督的HIRT训练，为期12周。一个非随机的FSMC评分匹配组（n = 69）作为非干预对照组。
HIRT组之间的主要和大多次要终点差异无统计学意义。A组FSMC评分的平均差异（95%置信区间）为-10.9（-14.8；-6.9），B组为-9.8（-13.2；-6.3）。联合HIRT组与非干预对照组的相应值分别为-10.3（-12.9；-7.7）和1.5（-0.6；3.6），p<0.001。两个HIRT组的次要终点也有所改善，不过只有医院焦虑抑郁量表中的焦虑以及MS影响量表-29心理分量表显著有利于每周两次的HIRT训练（A组）。作为一个探索性终点，血浆炎症蛋白标志物的变化与汇总资料中FSMC评分的降低相关。
疲劳的PwMS患者进行HIRT训练可使自我报告的疲劳在临床上显著减轻，且与血浆炎症蛋白水平的变化相关，这一发现为推荐对疲劳的PwMS患者进行HIRT训练提供了证据。
