Cardiopulmonary Exercise Testing Using the Modified Balke Protocol in Fully Ambulatory People With Multiple Sclerosis.
Coery D Feasel, Brian M Sandroff, Robert W Motl
PMID 36380901WHAT IT FOUND
A treadmill cardiopulmonary exercise test was safe and feasible for people with multiple sclerosis who could walk without aids.
Seventeen of twenty tests provided usable data. The results correlated with walking distance, cognitive speed, and disability levels, supporting its use for assessment.
Key findings
01The modified Balke treadmill protocol was safe, with no adverse events reported before, during, or after testing.
02Seventeen of the twenty tests met the criteria for maximal exertion, making them interpretable for clinical use.
03Peak oxygen uptake was positively correlated with walking endurance and cognitive processing speed, and negatively correlated with neurological disability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was small (n = 20) and not powered by a prior calculation. The study only included fully ambulatory people with mild to moderate disability, so results do not apply to those with severe mobility impairment. Blood lactate was not measured, which is a standard criterion for confirming maximal effort. Participants were allowed to hold handrails for safety, which may have affected physiological responses like respiratory exchange ratio. There was no follow-up 24 to 48 hours after the test to capture delayed adverse events.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the high correlation between aerobic power and cognitive scores as evidence that exercise improves cognition. This is a cross-sectional study, so it only shows that these factors are related in people with MS, not that one causes the other.