Aerobic Cycling May Improve Pain and Fatigue in Patients With MS

Aerobic cycling is associated with improvements in pain and fatigue in patients with multiple sclerosis (MS), according to study results presented at the 2023 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held from May 31 to June 3 in Aurora, Colorado.

Individuals with MS often experience pain and fatigue, which negatively affects their quality of life (QoL) and are largely unresponsive to traditional pharmacologic therapies. Although the use of aerobic exercise is known to be effective in the management of MS symptoms, individuals with MS exhibit lower levels of physical activity because of impairments such as weakness, spasticity, and fatigue. These disabilities, in turn, prevent their participation in intensive aerobic exercise.

The use of a forced-rate aerobic cycling intervention has been associated with improved QoL and fatigue among patients with other neurologic conditions, including stroke and Parkinson disease. To date, however, the use of forced exercise (FE) has not been evaluated in individuals with MS. With this intervention, use of a motor-assisted bicycle facilitates high-cadence cycling. 

Researchers sought to establish the feasibility of a 12-week high-intensity FE or voluntary aerobic exercise (VE) intervention, and to examine the impact on health-related QoL and fatigue in patients with MS.

For the study, the researchers enrolled a total of 18 participants and divided them into 2 groups: the FE group (n=11) and the VE group (n=7). All of the participants completed a total of 24 aerobic cycling sessions over 12 weeks at 60% to 80% of their age-predicted maximum heart rate.

Individuals in the VE group exercised on a standard semirecumbent bicycle without any assistance. Participants in the FE group completed aerobic cycling on a motorized cycle that supplemented pedaling cadence. Scores on the Modified Fatigue Impact Scale (MFIS) and the Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) were applied to evaluate all participants at baseline and following use of the intervention. The 2 groups were assessed together, and prepost comparisons were calculated with the use of paired t tests.

The researchers found that participants in both groups tolerated the intensive cycling intervention. The following findings were noted:

• Participants exercised for an average of 42.2±2.3 minutes
• The average cadence was 67.3±13.3 revolutions per minute
• The average aerobic intensity was 65%±7% of maximum

Both groups reported statistically significant improvements from baseline:

• Overall MFIS score: 21.9 to 17.0 (P =.013)
• MFIS physical subscale: 14.1 to 10.5 (P =.005)
• Pain interference subsets of PROMIS-29: 52.2 to 47.7 (P =.013)
• Pain intensity on PROMIS-29: 3.5 to 2.8 on a 1-point to 10-point scale (P =.007)

“These results suggest that aerobic cycling is a feasible intervention in persons with MS and a viable treatment option to improve fatigue and pain, complementing medical therapies,” the researchers concluded.

Disclosure: One of the study authors has declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of the author’s disclosures.