Exercise studies including only fatigued persons with multiple sclerosis (PwMS) with fatigue as primary endpoint are lacking.

To evaluate the effects of high-intensity resistance training (HIRT) on self-reported fatigue in fatigued PwMS in a single center randomised controlled trial.

We recruited 71 PwMS scoring ≥ 53 on the Fatigue Scale for Motor and Cognitive Functions (FSMC), who were randomised 1:1 to either twice (group A) or once (group B) weekly supervised HIRT for twelve weeks. A non-randomised FSMC score-matched group (n=69) served as non-intervention control.

Between HIRT-group differences were non-significant for primary and most secondary endpoints. Mean difference in FSMC score (95% confidence intervals) was -10.9 (-14.8; -6.9) in group A and -9.8 (-13.2; -6.3) in group B. Corresponding values for combined HIRT groups vs non-intervention control were -10.3 (-12.9; -7.7) and 1.5 (-0.6;3.6), respectively, p<0.001. Secondary endpoints also improved in both HIRT groups, though only Hospital Anxiety and Depression Scale anxiety and MS Impact Scale-29 psychological subscales significantly favoured the twice a week HIRT (group A). As an exploratory endpoint, changes in plasma inflammatory protein markers were associated with reduced FSMC scores in the pooled material.

The finding that HIRT in fatigued PwMS leads to clinically relevant reductions in self-reported fatigue, associated with changes in plasma inflammatory protein levels, provide evidence for recommending HIRT for fatigued PwMS.

Multiple sclerosis

Fatigue

Randomised controlled trial

Exercise

Resistance training

Rehabilitation

Quality of Life

Inflammatory markers

Disease Modifying Therapy

Expanded Disability Status Scale

5-level EQ-5D version

EuroQoL Visual Analogue Scale

Fatigue Scale for Motor and Cognitive Functions

Fatigue Severity Scale

Hospital Anxiety and Depression Scale

High-Intensity Resistance Training

Health-Related Quality of Life

Multiple Sclerosis Impact Scale

Normalized Protein Expression

Occupational Gaps Questionnaire

Primary Progressive Multiple Sclerosis

Persons with Multiple Sclerosis

Randomised Controlled Trial

Relapsing Remitting Multiple Sclerosis

Symbol Digit Modalities Test

Secondary Progressive Multiple Sclerosis

© 2022 The Authors. Published by Elsevier B.V.