Targeting Vascular Mechanisms of Functional Outcomes Via Home-based Exercise Training Among Persons With Multiple Sclerosis Who Have Hypertension
University of Massachusetts, Boston
Summary
The goal of this study is to determine if 12 weeks of cycling exercise training at home will improve three parameters: 1) blood pressure, 2) cognition, and 3) walking ability among persons with multiple sclerosis who have high blood pressure, when compared to a group that engages in a 12-week home-based stretching program. The main questions this study aims to answer are: 1. Can home-based cycling exercise training improve blood pressure by increasing blood vessel dilation in people with multiple sclerosis? 2. Can cycling exercise training improve cognition and walking mobility in people with multiple sclerosis by improving blood pressure? The investigators will compare home-based cycling training to stretching to see if cycling training improves cognition, walking mobility, blood pressure, and fitness in people with multiple sclerosis. Participation in this study will take 13-14 weeks, with participants being randomized (like flipping a coin, a 50-50 chance of being in either group) to the home-based cycling training or the stretching group. All participants will be asked to * Visit the laboratory two times, one before the beginning of the intervention (home-base training and stretching group) and one at the end of the intervention. * During visits, participants will complete tests related to cognition, walking mobility, blood pressure and fitness.
Description
Functionally, the disease pathophysiology of multiple sclerosis (MS) brings about a number of consequences, including cognitive dysfunction and mobility disability, which are two of the most prevalent outcomes of MS. Cognitive impairments typically occur in domains of mental processing speed and working memory and is present in 40-70% of patients with MS based on neuropsychological testing. Cognitive impairment compromises quality of life, activities of daily living, employment, and independent living in persons with MS, and co-occurs with decrements in physical abilities. Mobility disability…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Persons with confirmed multiple sclerosis diagnosis with Expanded Disability Status Scale scores of 4-6.5, characteristic of 2nd stage of multiple sclerosis; * Hypertension defined as elevated, or Stage 1 or 2, as per the 2017 American Heart Association guidelines (brachial systolic blood pressure \> 120 mmHg or brachial diastolic blood pressure \> 80 mmHg) * Persons who are physically inactive (less than 60 min/wk of physical activity); * Persons with body mass index \< 40 kg/m2; * Persons who are not confined to a wheel chair; * Multiple sclerosis relapse in the past 3…
Interventions
- BehavioralHome-based aerobic training
The aerobic training will focus on large, dynamic movements of the lower extremities using leg cycling ergometry on an upright cycle ergometer installed in the participant's homes and will progress in duration (10-40 minutes) and intensity (50-70% VO2 peak) over the 3-month intervention period. All participants will start exercise at 50% of VO2peak for 10-min as determined by the exercise test, for the first week, to individualize the exercise prescription. Progression will initially target duration with weekly progressions of 5 min to 30 min of exercise, followed by progression of intensity by 5% per week until 70% is attained, based on patient tolerance of the increased work.
Location
- UMass BostonBoston, Massachusetts