Power Training in Older Multiple Sclerosis Patients

NCT ID: NCT04762342

Last Updated: 2023-06-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-07

Study Completion Date

2024-08-28

Brief Summary

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The study seeks to investigate whether 24 weeks of power training has neuroprotective effects in older PwMS. Additional purposes are to examine the effects of 24 weeks power training on physical function, cognitive function and neuromuscular function. Further, it is investigated whether the potential effects of power training are maintained after 24 weeks of follow-up.

Detailed Description

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Over the past 3-4 decades, the lifespan among people with multiple sclerosis (MS) has increased substantially. Today more than one-third of all people with MS are 60 years or older. With advanced age, people with MS are more likely to have impairments in cognitive and physical function.

Positive adaptations within the nervous system (\~neuroplasticity) have been shown to occur in people with MS following periods of resistance training (RT). This resembles the observations in young and old healthy individuals. Moreover, a specific type of RT termed power training appears to be particularly beneficial, as it emphasizes an explosive concentric phase of muscle contraction. This taxes the nervous system to a very high extent. As a result, power training has been shown to improve several aspects that rely on the nervous system in older individuals without MS. These aspects include cognition, neuromuscular function, and physical function.

The investigators speculate that older people with MS would also benefit. However, no studies have looked into the effects of power training in older people with MS.

Conditions

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Multiple Sclerosis Sclerosis Demyelinating Autoimmune Diseases, CNS Autoimmune Diseases of the Nervous System Demyelinating Diseases Healthy Aging Aging

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Training Group Multiple Sclerosis

24 weeks of moderate to high-intensity power training (resistance training- emphasizing an explosive concentric phase of muscle contraction) performed twice weekly.

Balance- and functional exercises are included after week 8.

Group Type EXPERIMENTAL

Power training

Intervention Type OTHER

First a brief warm up on a stationary bike and uni-lateral knee raises is completed.

Power training: Involves exercises performed with fast/explosive muscle contraction during the concentric phase, and slow/controlled (approximately 2-3 s) muscle contraction during the eccentric phase.

Functional- and balance exercises are included from week 9-24.

Progression:

Week 1-4: 3 sets of 12 repetitions at a load of 14 repetitions maximum (RM) with focus on introducing resistance exercise and familiarizing participants with exercises.

Week 5-8: 3 sets of 12 repetitions at a load of 14 RM the power training component.

Week 9-16: 3 sets of 10 repetitions at a load of 12 RM. Week 17-24: 3 sets of 8 repetitions at a load of 10 RM

Strengthening exercises:

* Bilateral leg-press
* Bilateral plantar flexion
* Bilateral knee extension
* Unilateral banded dorsal flexion
* Bilateral lying leg curl
* Back extension
* Shoulder press
* Seated row
* Chest press
* Lat pull-down

Control Group Multiple Sclerosis

Habitual lifestyle including standard care.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Power training

First a brief warm up on a stationary bike and uni-lateral knee raises is completed.

Power training: Involves exercises performed with fast/explosive muscle contraction during the concentric phase, and slow/controlled (approximately 2-3 s) muscle contraction during the eccentric phase.

Functional- and balance exercises are included from week 9-24.

Progression:

Week 1-4: 3 sets of 12 repetitions at a load of 14 repetitions maximum (RM) with focus on introducing resistance exercise and familiarizing participants with exercises.

Week 5-8: 3 sets of 12 repetitions at a load of 14 RM the power training component.

Week 9-16: 3 sets of 10 repetitions at a load of 12 RM. Week 17-24: 3 sets of 8 repetitions at a load of 10 RM

Strengthening exercises:

* Bilateral leg-press
* Bilateral plantar flexion
* Bilateral knee extension
* Unilateral banded dorsal flexion
* Bilateral lying leg curl
* Back extension
* Shoulder press
* Seated row
* Chest press
* Lat pull-down

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* ≥ 60 years of age.
* Clinically diagnosed with MS according to the McDonald criteria (48).
* Having an EDSS ≤ 6.5.
* able to transport themselves to the testing at Aarhus University and Aarhus University Hospital.
* able to transport themselves to training, if randomized to the PRP group.

Exclusion Criteria

* having comorbidities (cardiovascular, respiratory, orthopedic, or other neurological diseases than MS) affecting PRP participation or MRI scans.
* having a pacemaker.
* having metallic implant(s) that prevents MRI scans.
* having untreated osteoporosis; t-score below -2.5 and a history of low energy facture or t-score below -3.0.
* participating in more than two sessions per week of structured PRE and have done so for the past 3 months.
* Are cognitively impaired at a level expected to prevent the participant from understanding training and testing instructions.
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Southern Denmark

OTHER

Sponsor Role collaborator

University of Copenhagen

OTHER

Sponsor Role collaborator

University of Aarhus

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tobias Gaemelke, Msc

Role: PRINCIPAL_INVESTIGATOR

Exercise Biology, Department of Public Health, Aarhus University

Locations

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Tobias Gæmelke

Aarhus C, , Denmark

Site Status RECRUITING

Countries

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Denmark

Central Contacts

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Tobias Gaemelke, MSc

Role: CONTACT

+45 28264508

Facility Contacts

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Tobias K. Gaemelke, Msc

Role: primary

+45 28264508

References

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Hurwitz BJ. Analysis of current multiple sclerosis registries. Neurology. 2011 Jan 4;76(1 Suppl 1):S7-13. doi: 10.1212/WNL.0b013e31820502f6.

Reference Type BACKGROUND
PMID: 21205683 (View on PubMed)

Marrie R, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T. Comorbidity, socioeconomic status and multiple sclerosis. Mult Scler. 2008 Sep;14(8):1091-8. doi: 10.1177/1352458508092263.

Reference Type BACKGROUND
PMID: 18728060 (View on PubMed)

Hvid LG, Strotmeyer ES, Skjodt M, Magnussen LV, Andersen M, Caserotti P. Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults - A randomized controlled trial. Exp Gerontol. 2016 Jul;80:51-6. doi: 10.1016/j.exger.2016.03.018. Epub 2016 Apr 14.

Reference Type BACKGROUND
PMID: 27090485 (View on PubMed)

Aagaard P, Suetta C, Caserotti P, Magnusson SP, Kjaer M. Role of the nervous system in sarcopenia and muscle atrophy with aging: strength training as a countermeasure. Scand J Med Sci Sports. 2010 Feb;20(1):49-64. doi: 10.1111/j.1600-0838.2009.01084.x.

Reference Type BACKGROUND
PMID: 20487503 (View on PubMed)

Schoenfeld BJ, Contreras B, Willardson JM, Fontana F, Tiryaki-Sonmez G. Muscle activation during low- versus high-load resistance training in well-trained men. Eur J Appl Physiol. 2014 Dec;114(12):2491-7. doi: 10.1007/s00421-014-2976-9. Epub 2014 Aug 12.

Reference Type BACKGROUND
PMID: 25113097 (View on PubMed)

Best JR, Chiu BK, Liang Hsu C, Nagamatsu LS, Liu-Ambrose T. Long-Term Effects of Resistance Exercise Training on Cognition and Brain Volume in Older Women: Results from a Randomized Controlled Trial. J Int Neuropsychol Soc. 2015 Nov;21(10):745-56. doi: 10.1017/S1355617715000673.

Reference Type BACKGROUND
PMID: 26581787 (View on PubMed)

Liu-Ambrose T, Nagamatsu LS, Graf P, Beattie BL, Ashe MC, Handy TC. Resistance training and executive functions: a 12-month randomized controlled trial. Arch Intern Med. 2010 Jan 25;170(2):170-8. doi: 10.1001/archinternmed.2009.494.

Reference Type BACKGROUND
PMID: 20101012 (View on PubMed)

Reid KF, Martin KI, Doros G, Clark DJ, Hau C, Patten C, Phillips EM, Frontera WR, Fielding RA. Comparative effects of light or heavy resistance power training for improving lower extremity power and physical performance in mobility-limited older adults. J Gerontol A Biol Sci Med Sci. 2015 Mar;70(3):374-80. doi: 10.1093/gerona/glu156. Epub 2014 Sep 8.

Reference Type BACKGROUND
PMID: 25199912 (View on PubMed)

Caserotti P, Aagaard P, Larsen JB, Puggaard L. Explosive heavy-resistance training in old and very old adults: changes in rapid muscle force, strength and power. Scand J Med Sci Sports. 2008 Dec;18(6):773-82. doi: 10.1111/j.1600-0838.2007.00732.x. Epub 2008 Jan 30.

Reference Type BACKGROUND
PMID: 18248533 (View on PubMed)

Bottaro M, Machado SN, Nogueira W, Scales R, Veloso J. Effect of high versus low-velocity resistance training on muscular fitness and functional performance in older men. Eur J Appl Physiol. 2007 Feb;99(3):257-64. doi: 10.1007/s00421-006-0343-1. Epub 2006 Dec 5.

Reference Type BACKGROUND
PMID: 17146693 (View on PubMed)

Earles DR, Judge JO, Gunnarsson OT. Velocity training induces power-specific adaptations in highly functioning older adults. Arch Phys Med Rehabil. 2001 Jul;82(7):872-8. doi: 10.1053/apmr.2001.23838.

Reference Type BACKGROUND
PMID: 11441371 (View on PubMed)

Henwood TR, Riek S, Taaffe DR. Strength versus muscle power-specific resistance training in community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2008 Jan;63(1):83-91. doi: 10.1093/gerona/63.1.83.

Reference Type BACKGROUND
PMID: 18245765 (View on PubMed)

Kupjetz M, Langeskov-Christensen M, Riemenschneider M, Inerle S, Ligges U, Gaemelke T, Patt N, Bansi J, Gonzenbach RR, Reuter M, Rosenberger F, Meyer T, McCann A, Ueland PM, Eskildsen SF, Nygaard MKE, Joisten N, Hvid L, Dalgas U, Zimmer P. Persons With Multiple Sclerosis Reveal Distinct Kynurenine Pathway Metabolite Patterns: A Multinational Cross-Sectional Study. Neurol Neuroimmunol Neuroinflamm. 2025 Nov;12(6):e200461. doi: 10.1212/NXI.0000000000200461. Epub 2025 Sep 18.

Reference Type DERIVED
PMID: 40966534 (View on PubMed)

Gaemelke T, Laustsen C, Feys P, Folkestad L, Andersen MS, Jorgensen NR, Jorgensen ML, Jespersen SN, Ringgaard S, Eskildsen SF, Dalgas U, Hvid LG. Effects of power training in older patients with multiple sclerosis on neurodegeneration, neuromuscular function, and physical function. A study protocol for the "power training in older multiple sclerosis patients (PoTOMS) randomized control trial. Contemp Clin Trials Commun. 2024 Feb 19;38:101279. doi: 10.1016/j.conctc.2024.101279. eCollection 2024 Apr.

Reference Type DERIVED
PMID: 38444875 (View on PubMed)

Other Identifiers

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4168624

Identifier Type: -

Identifier Source: org_study_id

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