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Muscular, cardiac, ventilatory and metabolic dysfunction in patients with multiple sclerosis: Implications for screening, clinical care and endurance and resistance exercise therapy, a scoping review

  • Inez Wens
    Correspondence
    Corresponding author at: Hasselt University, Faculty of Medicine and Life Sciences, Agoralaan, Building A, 3590 Diepenbeek, Belgium.
    Affiliations
    REVAL – Rehabilitation Research Center, BIOMED- Biomedical Research Center, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
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  • Bert O. Eijnde
    Affiliations
    REVAL – Rehabilitation Research Center, BIOMED- Biomedical Research Center, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
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  • Dominique Hansen
    Affiliations
    REVAL – Rehabilitation Research Center, BIOMED- Biomedical Research Center, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium

    Jessa Hospital, Heart Centre Hasselt, Hasselt, Belgium
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      Highlights

      • Clinicians tend to focus on neurologic deficits only in pwMS and prefer to prescribe rehabilitation programs to counteract these deficits.
      • This review shows that pwMS also experience muscular, cardiac, ventilatory and metabolic dysfunction, which might contribute to exercise intolerance.
      • The impact of exercise intervention on these anomalies in MS patients are mostly unknown.
      • It is suggested that MS patients should be screened systematically for muscular, cardiac, ventilatory and metabolic function.

      Abstract

      In the treatment of multiple sclerosis (MS), exercise training is now considered a cornerstone. However, most clinicians tend to focus on neurologic deficits only, and thus prefer to prescribe rehabilitation programs specifically to counteract these deficits. However, the present comprehensive review shows that patients with MS (pwMS) also experience significant muscular, cardiac, ventilatory and metabolic dysfunction, which significantly contribute, next to neurologic deficits, to exercise intolerance. In addition, these anomalies also might increase the risk for frequent hospitalization and morbidity and can reduce life expectancy. Unfortunately, the impact of exercise intervention on these anomalies in pwMS are mostly unknown. Therefore, it is suggested that pwMS should be screened systematically for muscular, cardiac, ventilatory and metabolic function during exercise testing. The detection of such anomalies should lead to adaptations and optimisation of exercise training prescription and clinical care/medical treatment of pwMS. In addition, future studies should focus on the impact of exercise intervention on muscular, cardiac, ventilatory and metabolic (dys)function in pwMS, to contribute to improved treatment and care.

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