Simplified indices of exercise tolerance among patients with multiple sclerosis and healthy subjects: a cross-sectional study

Introduction Among patients with multiple sclerosis (MS), the impairment of exercise tolerance is closely related to functional limitations. Maximal oxygen uptake (VO2max) is the gold standard to assess exercise tolerance in healthy subjects (HS), but in patients with MS, the accuracy of VO2max measurement is often impaired because the patients are unable to reach the maximal exercise intensity due to inter-dependent factors linked to the disease (like pathological fatigue, pain, lack of exercise habit and lack of mobility). Aim To propose simple (i.e., measurable during submaximal exercise and/or not based on gas exchange analysis) indices for assessing exercise tolerance in patients with MS. Methods Thirty-nine patients with MS with mild disability and 30 HS performed an incremental exercise testing on a cycle ergometer up to volitional exhaustion. Simplified indices of exercise tolerance were computed. Results All indices were significantly lower in the MS group compared to the HC group (P<0.001). OUESs appeared highly correlated (>0.70,P<0.001) with VO2peak, in both groups, without difference between groups. PeakWR-based prediction of VO2peak presented a standard error of the estimate of 315ml.min-1 in HS and 176 ml.min-1 in MS. HR-based submaximal indices did not correlate to VO2peak in neither groups. Conclusion These findings suggest an impairment of exercise tolerance functions in persons with MS and mild disability, independently from other factors. In these patients, and in HS, submaximal indices involving gas exchange analysis or peakWR-based estimation of VO2peak based on are usable to assess accurately exercise tolerance.

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Valet, M., Stoquart, G., de Broglie, C., Francaux, M., & Lejeune, T. (2018). Simplified indices of exercise tolerance among patients with multiple sclerosis and healthy subjects: a cross-sectional study. Annual Congress of Physical and Rehabilitation Medicine, SRBMPR, Leuven. https://hdl.handle.net/2078.5/62913