Going for a bike ride is beneficial for you – also for patients with multiple sclerosis (MS). At least, a study from Aarhus University suggests that aerobic exercise reduces the number of attacks.

2020.12.17 | Helle Horskjær Hansen

For decades, people with MS were advised to avoid training so as to prevent fatigue and because their symptoms were sometimes temporarily exacerbated. However, today training is recommended and is part of most MS patients' rehabilitation. Research results from Aarhus University now show that the number of attacks in all probability decreases, if MS patients undertake systematic, high-intensity and prolonged aerobic exercise.

"The patients who took part in the trial experienced no attacks during the period in which they trained," says Martin Langeskov Christensen, who is behind the study. He emphasizes that this result was unexpected and therefore needs to be replicated in future studies.

86 patients with MS aged 18 to 65 years participated in the study. Of these, 43 trained intensively for 24 weeks, training twice a week with cycling, rowing and using a cross trainer, while the remainder lived as usual.

Prior to the intervention and afterwards, the trial participants went through a number of tests, including MRI scans of the central nervous system, and the number of attacks were registered.

The study also showed that the 24 weeks of training had no effect on total brain volume loss, which is the loss of nerve cells. Martin Langeskov Christensen emphasises that brain volume loss is a very slow process that occurs in all adults, regardless of whether they have MS or not, but that it usually takes place more quickly in people with MS, where it is related to the development of the disease.

In addition, the training also had a positive effect on the patients' cardiorespiratory fitness, with the training group improving significantly. As MS patients are generally less physically active than the general population, and their cardiorespiratory fitness is poorer, these findings underline the importance of MS patients undertaking high-intensity aerobic exercise, says the researcher.

The findings are published in Neurology.

"Physical training is widely accepted as an effective symptomatic treatment of patients with MS. Data from this study supports the assumption that training should be regarded as a complementary treatment, particularly in relation to patients with relapsing-remitting MS," says the researcher.

He emphasises that the results have given medical doctors further arguments towards convincing patients with MS to train, as training can potentially slow down the development of the disease.

"Despite the effectiveness of medical treatments which alter the pathological picture of the disease, MS remains an incurable and harmful disease. It’s therefore important to identify different interventions that can alleviate the disease," explains Martin Langeskov Christensen.

He hopes that the results of this project will inspire future studies that involve longer interventions and follow-up periods (of more than a year), as well as more refined MRI techniques.

"This will give us the opportunity to fully understand the potential neuro-protective effects of training on patients with MS and further expand our knowledge about the disease mechanisms," says Martin Langeskov Christensen.

Multiple sclerosis

There are more than 16,500 people in Denmark who live with an MS diagnosis. Around two-third of them are women. Generally, the disease begins with attacks that can affect different parts of the central nervous system – from the optic nerves to the brain or the spinal cord. This means that in the beginning, MS patients may experience visual disturbances, sensory disturbances or experience losing strength in their limbs. The disease typically develops with the patient having repeated attacks.

Background for the results

• The study is a randomised, controlled trial (RCT).
• Partners: The MR Research Centre at Aarhus University Hospital; The Center of Functionally Integrative Neuroscience at Aarhus University; The Department of Sports Science and Clinical Biomechanics at The University of Southern Denmark; and the neurological departments at the hospitals in Aarhus, Odense, Kolding and Viborg.
• Funded by: The Jascha Foundation; The Foundation for Neurological Research; The Danish Multiple Sclerosis Society; The Aase & Ejnar Danielsens Foundation; The Knud & Edith Eriksens Foundation; The Augustinus Foundation; Director Emil C. Hertz & Hustru Inger Hertz Foundation; Else & Mogens Wedell-Wedellsborgs Foundation; and Karen A. Tolstrups Foundation.
  The scientific article can be read in Neurology.

Contact
Martin Langeskov Christensen
Aarhus University, Department of Public Health
mach@ph.au.dk

50 94 45 21