MS Research Translated: How to Reduce Fatigue During Exercise

By Crystal R. Mendoza Paulin

I’ve been agonizing over how to start this article for ages. I know with subjects like this people usually start with something politically incorrect or humorous to be “relatable” or “cool”. But I’m not a cool person; I am a giant nerd and it’s because I am a giant nerd that I am equipped to explain, or translate, if you will, a research paper in colloquial terms to you. So strap yourselves in kids it’s time for some SCIENCE.

While exercise offers many long-term benefits for people living with MS, it can be risky and unsafe in the short-term.

Okay, so this study was conducted by researchers from Memorial University of Newfoundland in Canada. These researchers were interested in finding a safe way for people living with MS to exercise. Why?

Previous research has repeatedly shown that routine exercise delays the onset of symptoms associated with MS. Exercise doesn’t cure MS but it certainly helps people
feel better for longer.

Unfortunately, exercise increases body temperature (you feel hot when you work out, right? Really annoying.) which can be dangerous for people living with MS. Fatigue is also a big problem for people living with MS and exercise generally makes that worse. So while exercise offers many long-term benefits for people living with MS, it can be risky and unsafe in the short-term. Thus, researchers hoped the results of this study would help them find a way to limit the negative effects of exercise— increased body temperature and fatigue— for people living with MS.

The study used 14 volunteers from a local MS clinic as subjects for this study. It is important to note two things from this:

  1. This was not a randomized study. The subjects for this study were not selected at random— they volunteered to participate in this study. Of course, volunteering for a study is not a bad thing, but the fact that all of the subjects were drawn from a single MS clinic does limit the conclusions we can draw from this study. The results may be valid for people living with MS in Newfoundland, but might not be reflective of people living with MS throughout the world.

  2. This was a small study. In research, the more subjects you have, the more likely it is that your results are accurate. The exact number of subjects needed for an accurate study is debatable, but a minimum of 30 is a widely accepted benchmark. Since this study used 14 subjects— less than the standard minimum of 30— this means the results may be valid for the subjects that volunteered for this study, but might not be reflective of the greater MS population.

TLDR: The results of this pioneering study should be taken with a grain of salt until further research is done.

Okay, so once researchers had subjects, they could begin their study. Researchers wanted to see if different exercise methods and conditions would affect body temperature and performance. They hypothesized that lowering the temperature of the room would prevent body temperature in people living with MS from increasing dramatically, therefore improving performance. They also hypothesized that a seated exercise would reduce fatigue and improve performance. To test these hypotheses, researchers selected two temperatures, 21°C (70°F) [standard room temperature] and 16°C (60°F), and two exercise methods, using a standing treadmill and a seated stepper, for their study.

Once a week, subjects would perform 30 minutes of aerobic exercise at these conditions:

  • Week 1: Standing treadmill at 21°C (70°F)

  • Week 2: Standing treadmill at 16°C (60°F)

  • Week 3: Seated stepper at 21°C (70°F)

  • Week 4: Seated stepper at 16°C (60°F)

Before and after each session, researchers would record the subject’s body temperature and level of fatigue. Subjects were also asked to perform two five-second toe points* before and after each session to test muscle performance.

*Toe points: A seated exercise where a subject lightly lifts their leg and points their toes down as hard as they can.

This study does suggest that lower environmental temperatures stabilize body temperature and improve physical performance.

If you’re still with me at this point, then congratulations! If you just skipped to the end to see the results, then congratulations to you too! You made it! The limited data from this study does suggest that lower environmental temperatures stabilize body temperature and improve physical performance. However, environmental temperature had no effect on perceived fatigue levels. Exercising on the seated stepper improved performance but also increased perceived levels of fatigue. Researchers think this is because the seated stepper is a full-body exercise method; subjects used more muscles on the seated stepper so they perceived higher fatigue during that exercise even though they physically performed better on the stepper than on the treadmill.

TLDR: Based on these results, researchers suggest individuals living with MS to exercise at cooler temperatures using full body exercise methods like a seated stepper. Individuals may feel more tired after using a seated stepper, but they will perform better, especially if they work out at cooler temperatures.

I hope this was useful for you to understand this pioneering study! If you are interested in reading the research paper in full, you can read it here for free. Of course, if you have any questions about any of this, feel free to leave a comment below!

If you're interested in keeping cool while you exercise, we have just the invisible cooling vest for you!