Cardiorespiratory response to different aerobic exercise modalities in people with advanced multiple sclerosis.

All three exercise modalities elicited cardiorespiratory responses corresponding to moderate-to-vigorous intensity exercise in people with advanced MS.

• Exercise intensity ranged from 58-68 %V̇O2peak across modalities
• Heart rate responses ranged from 79-88 %HRpeak across modalities
• Exercise was prescribed at a submaximal Rating of Perceived Exertion (RPE) of 12-13
• Each bout lasted 15 minutes
• Sample consisted of 18 people with advanced MS (n=15 female; mean age = 60.7 ± 11.1 years) who were wheelchair users

FES cycling produced lower cardiorespiratory and work rate responses compared to both arm cycle ergometer and recumbent stepper exercise at a matched RPE.

• Mean submaximal V̇O2 (mL/min, mL/(kg·min)-1, and %V̇O2peak) was lower for FES cycling vs. ACE (all p ≤ 0.042) and vs. RS (all p ≤ 0.036)
• HR (bpm and %HRpeak) was lower for FES cycling compared to both ACE and RS (all p ≤ 0.042 and p ≤ 0.036 respectively)
• Work rate (Watts and %WRpeak) and RER were also lower for FES cycling compared to both ACE and RS
• Despite lower physiological responses, RPE did not differ significantly across modalities (p = 0.317)

There were no significant differences in cardiorespiratory response between arm cycle ergometer and recumbent stepper exercise.

• No differences were found between ACE and RS for V̇O2, HR, WR, RER, or RPE
• Both modalities were compared during 15-minute submaximal bouts at RPE 12-13
• This was a repeated-measures study design with all participants completing all three modalities

The study characterized the acute cardiorespiratory response to three aerobic exercise modalities in people with advanced MS who were wheelchair users.

• Modalities tested were arm cycle ergometer (ACE), recumbent stepper (RS), and functional electrical stimulation (FES) leg cycle
• Outcome measures included oxygen consumption (V̇O2), heart rate (HR), work rate (WR), respiratory exchange ratio (RER), and RPE
• Participants had advanced MS defined by wheelchair use
• The study used a repeated-measures design of acute exercise

The findings support the potential for improving cardiorespiratory fitness through aerobic exercise in people with advanced MS.

• All modalities achieved moderate-to-vigorous intensity thresholds (58-68 %V̇O2peak; 79-88 %HRpeak)
• Prior evidence for exercise improving CRF in advanced MS was unclear before this study
• Exercise training is noted as effective for improving CRF in people with mild-to-moderate MS
• At a matched RPE, FES cycling may provide a less demanding aerobic stimulus