Multiple Sclerosis
Conditions
Keywords
Multiple sclerosis, Cooling, Heating, Fatigue, Exercise
Brief summary
Local head and neck cooling strategies can help reduce multiple sclerosis-related fatigue, while heating can exacerbate heat-related fatigue. However, no study has detailed the peripheral and central responses to head and neck cooling (at 18°C) and heating (at 43 ± 1°C next to the scalp and neck skin) during fatiguing isometric exercise in non-challenging ambient temperature in multiple sclerosis and healthy male subjects. In addition, there is a lack of data describing the effects of head and neck cooling/heating and strenuous exercise on blood markers, muscle temperature, motor accuracy, and rate of perceived exertion. The investigators hypothesized that: (i) men with multiple sclerosis would be more affected by central and peripheral fatigue compared to healthy subjects; (ii) local cooling will result in greater central fatigue but will be associated with greater peripheral fatigue, whereas heating will result in greater central and peripheral fatigue in multiple sclerosis men; (iv) local cooling and heating will have a greater effect on the release of stress hormones, rate of perceived exertion and motor accuracy compared to the control condition in both multiple sclerosis and healthy groups.
Interventions
OTHERCooling of the head and neck
Cooling of the head and neck at 18°C next to the head and neck skin in multiple sclerosis and healthy subjects
OTHERHeating of the head and neck
Heating of the head and neck at 43 ± 1°C next to the head and neck skin in multiple sclerosis
Sponsors
Lithuanian Sports University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
NONE
Masking description
The researchers who analyzed the venous blood samples were blinded.
Eligibility
Sex/Gender
MALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* Relapsing-remitting multiple sclerosis disease course according to McDonald criteria * Expanded Disability Status Scale less than 4 points and Fatigue Severity Scale score greater than 5 points in participants with multiple sclerosis * Males * Age between 18 and 45 years * Sufficient tolerance to electrical stimulation
Exclusion criteria
* Physical limitations that would impair the ability to perform neuromuscular testing * Mental disorders, such as depression or anxiety, due to their recognized association with fatigue * Involvement in temperature manipulation program for ≥ 3 months * Attending any excessive physical exercise or sports programs * With blood/needle phobia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in absolute error | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | The absolute error specifies the absolute deviation from the required target force. Absolute error = ∑\|xi - T\|/n where xi is the motor task performed (N·m); T is the target quantity, i.e., the motor task required; n is the number of trials; and vertical brackets Σ \| \| indicate the mean that was calculated without considering the algebraic symbols (±). |
| Body weight (kg) | Every time in all conditions at the baseline | Body weight (kg) was evaluated using Tanita Body Composition Analyzer (Japan). |
| Body fat (%) | Every time in all conditions at the baseline | Body fat (%) was assessed using Tanita Body Composition Analyzer (Japan). |
| Body free fat mass (kg) | Every time in all conditions at the baseline | Body free fat mass (kg) was evaluated using Tanita Body Composition Analyzer (Japan). |
| Body mass index (kg/m2) | Every time in all conditions at the baseline | The body mass index (in kg/m2) was defined as the body mass divided by the square of the body height. |
| Change in muscle temperature (°C) | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | Muscle temperature was measured using a needle microprobe (Intramuscular Probe MKA, thermometer model DM-852, Ellab) inserted approximately 3 cm beneath the skin surface into the vastus lateralis muscle of the right leg. |
| Change in plasma cortisol (nmol/L) concentrations | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | Plasma cortisol concentrations (nmol/L) were measured using an AIA-2000 automated enzyme immunoassay analyser (Tosoh Corp, Tokyo, Japan). |
| Change in plasma dopamine (nmol/L) concentrations | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | Dopamine concentrations (nmol/L) were measured using a kit for dopamine enzyme-linked immunosorbent assay (ELISA) (IBL, Hamburg, Germany). |
| Change in plasma prolactin (ng/mL) concentrations | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | Prolactin levels (ng/mL) were measured using a kit for prolactin ELISA (IBL) and Gemini analyzer (Stratec Biomedical GmbH, Germany). |
| Change in subjective rating of perceived exertion | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | Perceived exertion was assessed using the Borg scale, ranging from 6 (no exertion) to 20 (maximum exertion). |
| Change in muscle activity (mV) | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | Vastus medialis and vastus lateralis electromyographic (EMG) amplitude (in mV) parameters of muscular activity were measured using surface EMG (Biometrics, UK) thorough neuromuscular function assessment. |
| Change in muscle activity (Hz) | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | Vastus medialis and vastus lateralis muscles electromyographic (EMG) frequency (in Hz) parameters of muscular activity were measured using surface EMG (Biometrics, UK) thorough neuromuscular function assessment. |
| Change in voluntary torque (Nm) | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | Isometric and isokinetic voluntary torques (in Nm) of the quadriceps muscles were measured using an isokinetic dynamometer (Biodex Medical Systems, USA). |
| Change in involuntary torque (Nm) | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | Involuntary torque of the quadriceps muscles were measured using an isokinetic dynamometer (Biodex Medical Systems, USA) and a high-voltage stimulator (Digitimer DS7A, Digitimer, UK). Peak torques (in Nm) induced by electrical stimulation at 20 Hz,at 100 Hz, and at TT100 were measured. |
| Change in muscle contraction and relaxation (ms) | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | The contraction and half-relaxation time (in ms) were measured in 100Hz stimulated contractions. |
| Change in central activation ratio (percent) | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | To evaluate central activation ratio (CAR), a TT-100 Hz stimuli was superimposed on the maximal voluntary contraction (MVC), and the CAR was computed using the following equation: CAR = MVC/(MVC+TT-100 Hz) × 100percent, where where a CAR of 100 percent indicates complete activation of the exercising muscle and a CAR \< 100 percent indicates central activation failure or inhibition. |
| Change in constant error | Baseline, up to 60 minutes, up to 120 minutes, after 180minutes | The accuracy of the intermittent isometric contraction tasks was calculated as a constant error. Constant error = ∑(xi - T)/n where xi is the motor task performed (N·m); T is the target quantity, i.e., the motor task required; n is the number of trials; and Σ indicates the mean that was calculated considering the algebraic symbols (±). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Height (m) | Every time in all conditions at the baseline | Height (in m) was measured using a Harpenden anthropometer set (Holtain Ltd, UK) |
Countries
Lithuania
Outcome results
None listed