title: Ventilatory function during exercise in multiple sclerosis and impact of training intervention: cross-sectional and randomized controlled trial.
abstract: BACKGROUND
  Patients with MS (pwMS) often experience resting ventilatory anomalies. Ventilatory function during exercise and impact of long-term training intervention remains however uncertain.
  
  
  OBJECTIVE
  The aim of this study was to examine the ventilatory function during exercise and impact of a 6-month training intervention in pwMS.
  
  
  METHODS
  Combination of a cross-sectional (part 1) and randomized controlled trial (part 2).
  
  
  METHODS
  University rehabilitation facility.
  
  
  METHODS
  Caucasian patients with MS and healthy controls.
  
  
  METHODS
  In part 1, the ventilatory function during submaximal endurance exercise was compared between pwMS (N.=37) and healthy participants (N.=15). In part 2, pwMS were then randomly assigned to a 6-month training intervention (N.=16) or usual care (N.=11). Following training intervention, ventilatory function during exercise was re-evaluated.
  
  
  RESULTS
  Despite comparable relative exercise testing intensities between groups in part 1, significantly elevated steady-state exercise dead space/tidal volume ratio, O2 uptake and CO2 output equivalent, end-tidal O2 pressure, ratings of perceived exertion and lowered end-tidal CO2 pressure and O2 pulse was observed in pwMS (P<0.05). The degree of ventilatory dysfunction during exercise correlated significantly with ratings of perceived exertion and blood lactate content (P<0.05). In part 2, despite an improved exercise tolerance (based on reductions in heart rate, blood lactate content and ratings of perceived exertion during exercise at similar workload) after a 6-month training intervention, ventilatory dysfunction remained present during endurance exercise (P>0.05).
  
  
  CONCLUSIONS
  Patients with MS experience a ventilatory dysfunction during endurance exercise, which is related to worse exercise tolerance. This ventilatory anomaly remains present after long-term training intervention.
  
  
  CONCLUSIONS
  Patients with MS experience ventilatory dysfunction during exercise. This dysfunction is related to exercise tolerance and ratings of perceived exertion. Long-term exercise training did not remediate this ventilatory dysfunction. The systematic examination of the pulmonary/cardiovascular system at rest and during exercise is recommended in MS.
authors.affiliation: REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Center, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium - Dominique.hansen@uhasselt.be.
authors.forename: D
authors.initials: D
authors.lastname: Hansen
authors.forename: I
authors.initials: I
authors.lastname: Wens
authors.forename: C
authors.initials: C
authors.lastname: Keytsman
authors.forename: K
authors.initials: K
authors.lastname: Verboven
authors.forename: P
authors.initials: P
authors.lastname: Dendale
authors.forename: B O
authors.initials: BO
authors.lastname: Eijnde
mesh_terms: D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000534:rehabilitation*; D010807:Physical Endurance / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology*; D012129:Respiratory Function Tests; D016896:Treatment Outcome