title: Cardiovascular adaptation in people with multiple sclerosis following a twelve week exercise programme suggest deconditioning rather than autonomic dysfunction caused by the disease. Results from a randomized controlled trial.
abstract: BACKGROUND
  Guidelines for optimal exercise doses in people with multiple sclerosis (MS) have to be established. We need to ascertain the basic physiological and perceptual response and adaptation to different exercise doses in this clinical population.
  
  
  OBJECTIVE
  The aim of this paper was to explore the response during maximal and sub-maximal exercise in people with MS prior to and following two different twelve week exercise programmes.
  
  
  METHODS
  Sub-analysis of per protocol exercise data of a two group, single blinded, randomised control trial.
  
  
  METHODS
  Multicentre (community leisure and rehabilitation centres).
  
  
  METHODS
  Participants with MS assigned to a continuous (N.=12; mean±SE age=52.3±2.08; Barthel index median & range=19&13-20) or interval (N.=9; mean±SE age=49.3±3.5; Barthel index median & range=19&18-20) exercise programme.
  
  
  METHODS
  Cardiovascular, respiratory and perceptual exercise response and adaption was measured at maximal and sub-maximal levels of physical exercise prior to and following a twelve week exercise programme, delivered at different intensities.
  
  
  RESULTS
  Irrespective of the type of exercise programme followed, there was a significant increase in peak power (z=-1.98; P=0.05) and normalised oxygen uptake during unloaded cycling (z =-2.00; P=0.05). At discharge from the exercise programmes, the cardiovascular response to sub-maximal exercise had significantly changed (t(360) =-4.62; p<0.01).
  
  
  CONCLUSIONS
  The response in people with MS at maximal and sub-maximal levels of physical exercise following a twelve week programme is analogous to non-diseased adults.
  
  
  CONCLUSIONS
  Cardiovascular adaptation in people with MS following a twelve week exercise programme suggests deconditioning rather than autonomic dysfunction caused by the disease.
authors.affiliation: Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, UK - m.g.feltham@bham.ac.uk.
authors.forename: M G
authors.initials: MG
authors.lastname: Feltham
authors.forename: J
authors.initials: J
authors.lastname: Collett
authors.forename: H
authors.initials: H
authors.lastname: Izadi
authors.forename: D T
authors.initials: DT
authors.lastname: Wade
authors.forename: M G
authors.initials: MG
authors.lastname: Morris
authors.forename: A J
authors.initials: AJ
authors.lastname: Meaney
authors.forename: K
authors.initials: K
authors.lastname: Howells
authors.forename: C
authors.initials: C
authors.lastname: Sackley
authors.forename: H
authors.initials: H
authors.lastname: Dawes
mesh_terms: D000222:Adaptation, Physiological; D018493:Cardiovascular Deconditioning / Q000502:physiology*; D004739:England; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000534:rehabilitation*; D010101:Oxygen Consumption