High-intensity resistance training in multiple sclerosis — An exploratory study of effects on immune markers in blood and cerebrospinal fluid, and on mood, fatigue, health-related quality of life, muscle strength, walking and cognition

• High-intensity resistance training was evaluated in patients with multiple sclerosis.
• The training protocol was feasible for multiple sclerosis patients with low disability.
• Fatigue and health-related quality of life were clinically relevantly improved.
• Positive effects were found in peripheral pro-inflammatory cytokine levels.
• These results provide a basis for a larger randomized controlled trial.

BackgroundHigh-intensity resistance training is unexplored in people with multiple sclerosis.ObjectivesTo evaluate effects of high-intensity resistance training on immune markers and on measures of mood, fatigue, health-related quality of life, muscle strength, walking and cognition. Further, to describe participants' opinion and perceived changes of the training.MethodsTwenty patients with relapsing–remitting multiple sclerosis performed high-intensity resistance training at an intensity of 80% of one-repetition maximum, twice a week for 12 weeks. Blood and optional cerebrospinal fluid samples, and data on secondary outcome measures were collected before and after intervention. A study-specific questionnaire was used for capturing participants' opinion.ResultsSeventeen participants completed the study. Plasma cytokine levels of tumor necrosis factor were significantly decreased post-intervention (p = 0.001). Exploratory cytokine analyses in cerebrospinal fluid (n = 8) did not reveal major changes. Significant and clinically important improvements were found in fatigue (p = 0.001) and health-related quality of life (p = 0.004). Measures of mood (p = 0.002), muscle strength (p ≤ 0.001), walking speed (p = 0.013) and cognition (p = 0.04) were also improved. A majority of participants evaluated the training as very good and perceived changes to the better.ConclusionHigh-intensity resistance training in persons with relapsing remitting multiple sclerosis with low disability had positive effects on peripheral pro-inflammatory cytokine levels, led to clinically relevant improvements in measures of fatigue and health-related quality of life, and was well tolerated. These results provide a basis for a larger randomized trial.