High Intensity Aerobic and Resistance Exercise Can Improve Glucose Tolerance in Persons With Multiple Sclerosis: A Randomized Controlled Trial

Introduction: The prevalence of impaired glucose tolerance (IGT) is higher in persons with multiple sclerosis (MS) compared to healthy controls, indicating metabolic deficits that may increase comorbidity. In other populations, IGT can, at least partly, be reversed by intense physical exercise, but this is never investigated before in MS.

Aim: To investigate the effect of high intensity aerobic and resistance training on glucose tolerance and skeletal muscle GLUT4 content in MS.

Methods: Thirty-four persons with MS (aged 45 ± 3 years, EDSS 2.5 ± 1.07) were randomized into three groups, including a (1) sedentary control group (SED, n = 11), (2) 12-week high intensity interval plus resistance training group (HITR, n = 12), or (3) 12-week high intensity continuous aerobic training plus resistance training group (HCTR, n = 11). Before and after 12 weeks, glucose tolerance and skeletal muscle GLUT4 content were determined by an oral glucose tolerance test and analysis of a m.vastus lateralis biopsy, respectively.

Results: There were no significant changes for subjects of SED. From pre- to post-intervention, total area under the glucose curve (tAUC) decreased significantly in both HITR (-6.9 ± 6.2%) and HCTR (-11.0 ± 7.7%) (P < 0.05). Insulin tAUC decreased (-12.3 ± 14.7%) within HCTR and muscle GLUT4 content increased (+6.6 ± 4.5%) in HITR.

Conclusion: Twelve weeks of high intensity aerobic exercise in combination with resistance training improved glucose tolerance in persons with MS.