Effects of inpatient energy management education and high-intensity interval training on health-related [QoL] in persons with [MS]... 2023 Patt et al

Full title: Effects of inpatient energy management education and high-intensity interval training on health-related quality of life in persons with multiple sclerosis: A randomized controlled superiority trial with six-month follow-up

Highlights

• Inpatient energy management education (IEME) + HIIT was compared to usual care.
• IEME + HIIT was not superior regarding HRQoL (Physical and mental component Scales).
• IEME + HIIT had higher scores in VȮ2peak, self-efficacy and some HRQoL subscales.
• IEME + HIIT had lower scores in anxiety.
• Between-group differences were significant for single time-points and outcomes.

Abstract

Background
Fatigue is one of the most frequent symptoms in persons with multiple sclerosis (pwMS) and impacts health-related quality of life (HRQoL). A multidisciplinary rehabilitation approach is recommended for the treatment of fatigue in pwMS. However, high-quality evidence exists only for unimodal interventions, such as physical therapies/exercise or energy/fatigue management programmes. The primary objective of the current study was to test the hypothesis that a combination of inpatient energy management education (IEME) and high-intensity interval training (HIIT) is superior to a combination of progressive muscle relaxation (PMR) and moderate continuous training (MCT) for improving HRQoL at 6-month follow-up in fatigued pwMS.

Methods
A randomized (1:1) controlled superiority trial with fatigued pwMS >18 years of age, with Expanded Disability Status Scale (EDSS) score ≤6.5, recruited at the Valens clinic, Switzerland. Participants in the experimental group performed IEME twice and HIIT 3 times per week and those in the usual care group performed PMR twice and MCT 3 times per week, during a 3-week inpatient rehabilitation stay. Primary outcome was HRQoL (Physical and Mental Component Scales of the Medical Outcome Study 36-item Short Form Health Survey (SF-36)), assessed at entry to the clinic (T0), after 3 weeks' rehabilitation (T1) and 4 (T2) and 6 (T3) months after T0. Secondary outcomes included SF-36 subscales, fatigue (Fatigue Scale for Motor and Cognitive Functions (FSMC)), mood (Hospital Anxiety and Depression Scale (HADS)), self-efficacy for performing energy conservation strategies (Self-Efficacy for Performing Energy Conservation Strategies Assessment (SEPECSA)), self-perceived competence in activities of daily living (Occupational Self Assessment (OSA)) and cardiorespiratory fitness (peak oxygen consumption (VȮ2peak)). Data were analysed using a mixed model for repeated measures approach.

Results
A total of 106 pwMS (age (years): 49.75 (9.87), 66% female, EDSS: 4.64 (1.32)) were recruited. There were no significant group × time interaction effects in the primary and secondary outcomes. There were significant between-group differences in the pairwise comparisons of the group × time interaction in favour of the IEME + HIIT group at: (i) T1 in cardiorespiratory fitness (p = 0.011) and SEPECSA (p = 0.032); (ii) T2 in SF-36 mental health subscale (p = 0.022), HADS anxiety subscale (p = 0.014) and SEPECSA (p = 0.040); (iii) T3 in SF-36 physical functioning subscale (p = 0.012) and SEPECSA (p = 0.003).

Conclusion
IEME + HIIT was not superior to PMR + MCT regarding the effects on HRQoL (SF-36 Physical and Mental Component Scales) at 6-month follow-up in pwMS. However, there were significant between-group differences in favour of IEME + HIIT in physical functioning and mental health (SF-36 subscales), anxiety (HADS), cardiorespiratory fitness (VȮ2peak) and self-efficacy (SEPECSA) at different measurement time-points that need to be considered in clinical practice.

Open access, https://www.msard-journal.com/article/S2211-0348(23)00430-3/fulltext

 

The premise is absurd. Why would it even do that? This is seriously getting into fanatical homeopathy territory. And of all modalities, HIIT? Good grief. Sometimes I get randomly reminded by my brain, it does that, that Corn Flakes were invented by some very religious dude with the intent of treating chronic masturbation in teenage boys, aka being teenage boys, and it makes every bit as much sense as this when you think about it for just a second.

And seriously measuring VO2peak makes as much sense as a trial for meth where an outcome is blood meth content. Of course there will be more meth in the blood of people who take meth, doesn't mean it's good. In this case, like us, it will likely come at costs, substitutions, and those are never taken into account. This silver bullet universal exercise-as-cure-for-everything lunacy has been going on for decades and it hasn't produced a damn thing other than an infinite cycle of chronic pseudoscience. But they still they try, again and again. Maybe they need Corn flakes for that.