BACKGROUND Aerobic training has the potential to restore function, stimulate brain repair, and reduce inflammation in people with Multiple Sclerosis (MS). However, disability, fatigue, and heat sensitivity are major barriers to exercise for people with MS. We aimed to determine the feasibility of conducting vigorous harness-supported treadmill training in a room cooled to 16 °C (10 weeks; 3times/week) and examine the longer-term effects on markers of function, brain repair, and inflammation among those using ambulatory aids. METHODS Ten participants (9 females) aged 29 to 74 years with an Expanded Disability Status Scale ranging from 6 to 7 underwent training (40 to 65% heart rate reserve) starting at 80% self-selected walking speed. Feasibility of conducting vigorous training was assessed using a checklist, which included attendance rates, number of missed appointments, reasons for not attending, adverse events, safety hazards during training, reasons for dropout, tolerance to training load, subjective reporting of symptom worsening during and after exercise, and physiological responses to exercise. Functional outcomes were assessed before, after, and 3 months after training. Walking ability was measured using Timed 25 Foot Walk test and on an instrumented walkway at both fast and self-selected speeds. Fatigue was measured using fatigue/energy/vitality sub-scale of 36-Item Short-Form (SF-36) Health Survey, Fatigue Severity Scale, modified Fatigue Impact Scale. Aerobic fitness (maximal oxygen consumption) was measured using maximal graded exercise test (GXT). Quality-of-life was measured using SF-36 Health Survey. Serum levels of neurotrophin (brain-derived neurotrophic factor) and cytokine (interleukin-6) were assessed before and after GXT. RESULTS Eight of the ten participants completed training (attendance rates ≥ 80%). No adverse events were observed. Fast walking speed (cm/s), gait quality (double-support (%)) while walking at self-selected speed, fatigue (modified Fatigue Impact Scale), fitness (maximal workload achieved during GXT), and quality-of-life (physical functioning sub-scale of SF-36) improved significantly after training, and improvements were sustained after 3-months. Improvements in fitness (maximal respiratory exchange ratio and maximal oxygen consumption during GXT) were associated with increased brain-derived neurotrophic factor and decreased interleukin-6. CONCLUSION Vigorous cool room training is feasible and can potentially improve walking, fatigue, fitness, and quality-of-life among people with moderate to severe MS-related disability. TRIAL REGISTRATION The study was approved by the Newfoundland and Labrador Health Research Ethics Board (reference number: 2018.088) on 11/07/2018 prior to the enrollment of first participant (retrospectively registered at ClinicalTrials.gov: NCT04066972. Registered on 26 August 2019.

中文翻译：

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进行剧烈的冷藏室跑步机训练，以提高使用移动辅助设备的多发性硬化症患者的步行能力：一项可行性研究。

背景技术有氧训练具有恢复多发性硬化症（MS）患者的功能，刺激大脑修复和减少炎症的潜力。但是，残疾，疲劳和热敏感性是MS患者锻炼的主要障碍。我们的目的是确定在冷却至16°C（10周； 3次/周）的房间内进行有力的线束支持的跑步机训练的可行性，并研究长期使用这些训练对功能，脑部修复和炎症指标的影响流动辅助工具。方法10名参与者（9名女性）年龄在29至74岁之间，其扩展的残疾状态量表范围为6至7，接受了以80％自行选择的步行速度开始的训练（心率储备为40至65％）。使用清单（包括出席率，错过约会的次数，不参加的原因，不良事件，训练期间的安全隐患，辍学的原因，对训练负荷的耐受性，运动期间和运动后症状恶化的主观报告以及运动的生理反应。在训练之前，之后和之后三个月评估功能结局。使用“定时25英尺步行”测试以及在仪表化人行道上以快速和自行选择的速度测量步行能力。使用36项简短表格（SF-36）健康调查的疲劳/能量/活力子量表，疲劳严重度量表，改进的疲劳影响量表来测量疲劳。使用最大分级运动测试（GXT）测量有氧健身度（最大耗氧量）。使用SF-36健康调查测量生活质量。在GXT前后评估血清神经营养蛋白（脑源性神经营养因子）和细胞因子（白介素6）的水平。结果十名参与者中有八名完成了培训（出勤率≥80％）。没有观察到不良事件。以自行选择的速度行走时的快步行速（cm / s），步态质量（双支撑（％）），疲劳（修正的疲劳影响量表），健康度（GXT期间达到的最大工作量）和生活质量（SF-36的生理功能子量表）在训练后有显着改善，并且在3个月后持续改善。体能的改善（GXT期间最大呼吸交换率和最大耗氧量）与脑源性神经营养因子增加和白介素6降低有关。结论进行剧烈的凉爽房间训练是可行的，并且可以潜在地改善中度至重度MS相关残疾患者的步行，疲劳，健身和生活质量。试验注册该研究已于2018年7月11日获得纽芬兰与拉布拉多健康研究伦理委员会（参考号：2018.088）的批准，然后才招募第一名参与者（该研究已在ClinicalTrials.gov上进行追溯注册：NCT04066972。于2019年8月26日注册。