High-intensity resistance training in people with multiple sclerosis experiencing fatigue: A randomised controlled trial

Background: Exercise studies including only fatigued persons with multiple sclerosis (PwMS) with fatigue as primary endpoint are lacking.Objective: To evaluate the effects of high-intensity resistance training (HIRT) on self-reported fatigue in fatigued PwMS in a single center randomised controlled trial. Methods: We recruited 71 PwMS scoring & GE; 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. Results: 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. Conclusion: The finding that HIRT in fatigued PwMS leads to clinically relevant reductions in self-reported fa-tigue, associated with changes in plasma inflammatory protein levels, provide evidence for recommending HIRT for fatigued PwMS.