title: Cardiopulmonary fitness is related to disease severity in multiple sclerosis.
abstract: BACKGROUND
  In persons with MS (pwMS), a lower cardiopulmonary fitness has been associated with a higher risk for secondary disorders, decreased functional capacity, symptom worsening and reduced health-related quality of life.
  
  
  OBJECTIVE
  To investigate the association between disease severity and cardiopulmonary fitness.
  
  
  METHODS
  Data from cardiopulmonary exercise tests, previously conducted in three different countries, were pooled. The association between disease severity (Expanded Disability Status Scale (EDSS)) and cardiopulmonary fitness (peak oxygen uptake (VO2peak)) was adjusted for age, sex and the country of origin.
  
  
  RESULTS
  The combined sample comprised 116 ambulant pwMS having a mean (± SD) EDSS score of 2.7 ± 1.3. There was a significant correlation (r = -0.418, p < .01) between VO2peak and EDSS. A multiple regression model (R(2) = 0.520, p < .01) was constructed to describe VO2peak (mL∙kg(-1)∙min(-1)); VO2peak = 36.622 - 5.433 (Sex (1=men)) - 0.124 (Age) - 2.082 (EDSS) + 2.737 (Belgium) + 8.674 (Denmark).
  
  
  CONCLUSIONS
  There was a significant association between disease severity and cardiopulmonary fitness. The close relation between cardiopulmonary fitness and chronic conditions associated with physical inactivity, suggest a progressive increase in risk of secondary health conditions in pwMS.
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands m.heine@dehoogstraat.nl.
authors.forename: Martin
authors.initials: M
authors.lastname: Heine
authors.affiliation: Rehabilitation Research Center (REVAL), Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Inez
authors.initials: I
authors.lastname: Wens
authors.affiliation: Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Langeskov-Christensen
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands.
authors.forename: Olaf
authors.initials: O
authors.lastname: Verschuren
authors.affiliation: Rehabilitation Research Center (REVAL), Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Bert O
authors.initials: BO
authors.lastname: Eijnde
authors.affiliation: Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Neurorehabilitation, Centre of Rehabilitation and Rheumatology READE, Amsterdam, The Netherlands.
authors.forename: Gert
authors.initials: G
authors.lastname: Kwakkel
authors.affiliation: Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Dalgas
mesh_terms: D000328:Adult; D001530:Belgium; D003718:Denmark; D005080:Exercise Test; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology*; D015999:Multivariate Analysis; D009426:Netherlands; D010101:Oxygen Consumption / Q000502:physiology*; D010809:Physical Fitness / Q000502:physiology*; D012720:Severity of Illness Index
keywords: Expanded Disability Status Scale; Multiple sclerosis; aerobic capacity; cardiopulmonary fitness; comorbidity; exercise test