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. 2016 Nov 14:7:531.
doi: 10.3389/fphys.2016.00531. eCollection 2016.

Effects of Six Months Training on Physical Capacity and Metaboreflex Activity in Patients with Multiple Sclerosis

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Effects of Six Months Training on Physical Capacity and Metaboreflex Activity in Patients with Multiple Sclerosis

Sara Magnani et al. Front Physiol. .

Abstract

Patients with multiple sclerosis (MS) have an increased systemic vascular resistance (SVR) response during the metaboreflex. It has been hypothesized that this is the consequence of a sedentary lifestyle secondary to MS. The purpose of this study was to discover whether a 6-month training program could reverse this hemodynamic dysregulation. Patients were randomly assigned to one of the following two groups: the intervention group (MSIT, n = 11), who followed an adapted training program; and the control group (MSCTL, n = 10), who continued with their sedentary lifestyle. Cardiovascular response during the metaboreflex was evaluated using the post-exercise muscle ischemia (PEMI) method and during a control exercise recovery (CER) test. The difference in hemodynamic variables such as stroke volume (SV), cardiac output (CO), and SVR between the PEMI and the CER tests was calculated to assess the metaboreflex response. Moreover, physical capacity was measured during a cardiopulmonary test till exhaustion. All tests were repeated after 3 and 6 months (T3 and T6, respectively) from the beginning of the study. The main result was that the MSIT group substantially improved parameters related to physical capacity (+5.31 ± 5.12 ml·min-1/kg in maximal oxygen uptake at T6) in comparison with the MSCTL group (-0.97 ± 4.89 ml·min-1/kg at T6; group effect: p = 0.0004). However, none of the hemodynamic variables changed in response to the metaboreflex activation. It was concluded that a 6-month period of adapted physical training was unable to reverse the hemodynamic dys-regulation in response to metaboreflex activation in these patients.

Keywords: blood pressure; cardiac output; cardiovascular regulation; stroke volume; systemic vascular resistance.

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Figures

Figure 1
Figure 1
Variation with respect to T0 in CPT parameters collected at T3 and T6. Brackets denote a significant group effect, *p < 0.05 between groups. Values are mean ± SD.
Figure 2
Figure 2
Responses due to metaboreflex activation in HR (A), SV (B), and CO (C) at T0, T3, and T6, respectively. Groups are the MSCTL (n = 10) and the MSIT (n = 11). Values are mean ± SD.
Figure 3
Figure 3
Responses due to metaboreflex activation in VFR (A) and PEP/VET (B) at T0, T3, and T6, respectively. Groups are the MSCTL (n = 10) and the MSIT (n = 11). Values are mean ± SD.
Figure 4
Figure 4
Responses due to metaboreflex activation in MBP (A) and SVR (B) at T0, T3, and T6, respectively. Groups are the MSCTL (n = 10) and the MSIT (n = 11). Values are mean ± SD.

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