High-intensity resistance training in people with multiple sclerosis experiencing fatigue: A randomised controlled trial, 2022, Englund et al

Abstract
Background
Exercise studies including only fatigued persons with multiple sclerosis (PwMS) with fatigue as primary endpoint are lacking.
Objective
To evaluate the effects of high-intensity resistance training (HIRT) on self-reported fatigue in fatigued PwMS in a single center randomised controlled trial.
Methods
We recruited 71 PwMS scoring ≥ 53 on the Fatigue Scale for Motor and Cognitive Functions (FSMC), who were randomised 1:1 to either twice (group A) or once (group B) weekly supervised HIRT for twelve weeks. A non-randomised FSMC score-matched group (n=69) served as non-intervention control.
Results
Between HIRT-group differences were non-significant for primary and most secondary endpoints. Mean difference in FSMC score (95% confidence intervals) was -10.9 (-14.8; -6.9) in group A and -9.8 (-13.2; -6.3) in group B. Corresponding values for combined HIRT groups vs non-intervention control were -10.3 (-12.9; -7.7) and 1.5 (-0.6;3.6), respectively, p<0.001. Secondary endpoints also improved in both HIRT groups, though only Hospital Anxiety and Depression Scale anxiety and MS Impact Scale-29 psychological subscales significantly favoured the twice a week HIRT (group A). As an exploratory endpoint, changes in plasma inflammatory protein markers were associated with reduced FSMC scores in the pooled material.
Conclusion
The finding that HIRT in fatigued PwMS leads to clinically relevant reductions in self-reported fatigue, associated with changes in plasma inflammatory protein levels, provide evidence for recommending HIRT for fatigued PwMS.

https://www.msard-journal.com/article/S2211-0348(22)00613-7/fulltext

 

I spent a lot of my earlier time with ME/CFS doing resistance training and it was manageable, I had to be very careful still a 30 minute work took 3 hours as it took a lot longer for my heart rate to drop and I had to sometimes cut it short but I was following doctors orders. Then I caught Long Covid and that resistance training turned into the worst crash it took me from mild to very severe over night. Prior to that I got no benefits over than body sculpt and weight improvements, it did not impact my fatigue at all consistently doing this 3 times a week for an entire year, it just pushed me into two crashes. From personal experience this finding is utterly at odds with what actually happened with ME/CFS patients. Maybe it helps MS patients but its not a good idea for ME/CFS at all, no exercise or exertion is.

 

Seems a bit garbled in conclusion?
“As an exploratory endpoint, changes in plasma inflammatory protein markers were associated with reduced FSMC scores in the pooled material.” sounds like it was a last minute thing to test it and yet it seems to be a foundation of their conclusion?
Not sure that that says the changes in reported fatigue was associated with changes in plasma inflammatory proteins.

But it would be good to have a study that took that conclusion, in its entirety, and (breaking it down into it’s component assertions) actually attempted to prove it. It’s not far off, but it’s jumping about a bit.

And this research is important. We need to know the answers to these sorts of questions.

Of course, all the usual issues with sample size (this is a test of whether it’s worth doing a study not a study that proves things), blinding, and subjective measures (which is why getting the plasma results really clear would help).

(Correct me if I’m just not reading the abstract right, there’s the odd acronym I don’t recognise in it)

 

Study shows that of those who have MS and a)can, and b) are motivated to, follow an exercise regime (apprx 50% of the initially identified cohort) feel better for doing exercise.

 

Exercise is obviously good for people, and can help manage many chronic conditions. We know unblinded subjective studies are low-quality evidence, so this study doesn't really prove that.

 

I didn't really think of it initially but it's pretty odd that there is a constant need to prove that exercise is good for this group of people while it's pretty much universally believed that it's good for everyone, although it's all average and generic. Is there a need to do hundreds of trials of whether average hydration is good for this patient population or that condition? Gulped down? Cold? Lukewarm? In a bottle? Obviously not, clearly a waste of resources.

Unless the point is to assess safety, possible issues specific to a population, etc. But that's never the case, the studies and trials are always built with the intent to prove that it's good, based on the knowledge that it's supposed to be good for everyone, clear outcome-seeking that would never recognize issues exactly based on this universal belief in being universally good (even though it's clearly false).

Even though the data on this is very conflicted, to the point where it seems like most of the benefits can be "seen" from just a few minutes of light exercise. But it's always about some specific type of exercise or another, to have distinction despite there being no reason why a specific type of exercise should be good other than whatever purpose that exercise has: strengthening muscle, conditioning, etc.

This frankly all seems as bad and random as nutrition science, where you can end up with headlines saying "eating eggs is great" and "eating eggs will kill you" published in the same edition because the research is just poor and all over the place.

Anyway it's beyond obvious that this entire paradigm is useless at giving answers, it's mostly a process that allows people's opinions to have false legitimacy.

Of course, though, it's always recreational exercise that's considered. People who work laborious jobs are never checked for this, even though it's basically the same. As if those people need to do anymore exercise than they already do.

And our back-breaking labor-intensive ancestors did not do a lot of dying of old age in good health and condition. Funny that.

 

They probably all ate the wrong egg(s).