Periodized home-based training: A new strategy to improve high intensity exercise therapy adherence in mildly affected patients with Multiple Sclerosis

Abstract Introduction Although high intensity exercise therapy (HIT) in Multiple Sclerosis (MS) induces substantial effects, longer term compliance to such a training program is not evident. When embedded in a periodized, home-based training strategy, high intensity exercise therapy adherence may improve. This is explored first in mildly affected persons with MS. Methods Exercise capacity (maximal exercise test) and body composition (DEXA) of healthy controls ( n  = 22) and persons with MS ( n  = 23, EDSS: 1.9 ± 1.1) were assessed at baseline (PRE). Next and within the context of an MS awareness project (climbing the Mont Ventoux, France), all participants were enrolled in a 6 m home-based periodized HIT oriented cycling program with remote (Polar® M200 activity tracker) supervision. Hereafter, POST measurements were performed similar to baseline. Results Six months of periodized and home-based HIT oriented training induced improvements in body weight (−3%, p  = 0.008), BMI (−3%, p  = 0.01), total mass (−2%, p  = 0.023), VO 2max (+ 5%, p  = 0.016), workload (+ 11%, p  = 0.001), time until exhaustion (+ 14%, p  = 0.001), recovery heart rate (+ 4%, p  = 0.04), lactate peak (+ 16%, p  = 0.03) and RER (+ 4%, p  = 0.04) in MS. Furthermore, all persons with MS safely reached the top of the Mont Ventoux, except for two. Conclusion The applied 6 m periodized, home-based and HIT-oriented cycling program provided good therapy adherence with similar improvements in exercise capacity compared to healthy controls. Furthermore, this exercise regimen trained mildly-affected persons with MS adequately to climb the Mont Ventoux.