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Acute High-Intensity Interval Exercise in Multiple Sclerosis with Mobility Disability


Medicine & Science in Sports & Exercise: May 2019 - Volume 51 - Issue 5 - p 858–867
doi: 10.1249/MSS.0000000000001866

Introduction Multiple sclerosis (MS) is an immune-mediated, neurological disease that results in physiological deconditioning with increasing disability. High-intensity interval training (HIIT) exercise has induced significant improvements in physiological conditioning in healthy and clinical populations and might be appropriate for persons with MS who have mobility disability. The feasibility and acute effects of HIIT using recumbent stepping in persons with MS who have mobility disability are relatively unknown.

Methods The physiological effects of single sessions of HIIT and continuous (CON), steady-state aerobic exercise using recumbent stepping were compared in 20 persons with MS with mobility disability (i.e., Expanded Disability Status Scale of 4.0–6.5). The HIIT bout included 10 cycles of 1-min intervals at the work rate associated with 90% peak aerobic capacity (V˙O2peak) followed by 1-min recovery intervals at 15 W, totaling 20 min in length. The CON bout consisted of 20 min at the work rate associated with 50% to 60% V˙O2peak. Physiological (i.e., power output, oxygen consumption, carbon dioxide expiration, respiratory exchange ratio, ventilation, HR, and core temperature) and perceptual (i.e., ratings of perceived exertion) measures were collected across the acute sessions.

Results There were statistically significant condition–time interactions for all physiological measures and ratings of perceived exertion expressing differential patterns of change over time for HIIT versus CON (P < 0.05). The main effect of condition was significant for all physiological outcomes, except core temperature, with the HIIT condition inducing significantly higher values than CON (P < 0.05).

Conclusions High-intensity interval training exercise taxes the cardiorespiratory system significantly more than CON, yet without deleterious effects on core temperature in persons with MS. This has important implications for informing an evidence-based exercise prescription that is appropriate for improving physiological conditioning in persons with MS who have mobility disabilities.

1Department of Kinesiology, Berry College, Mount Berry, GA;

2Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL; and

3College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL

Address for correspondence: Elizabeth A. Hubbard, Ph.D., PO Box 495026, Mount Berry, GA 30149-5026; E-mail:

Submitted for publication April 2018.

Accepted for publication November 2018.

© 2019 American College of Sports Medicine