Exercise in Severely Disabled Patients With MS

• Exercise compliance [ Time Frame: Exercise compliance is registered immediatly after all planned exercise sessions during the 4 week intervention ] [ Designated as safety issue: Yes ]
  Compliance to exercise is registered and serve as the primary outcome.
  
  
• Drop out rate [ Time Frame: Number of participants who drop out is registered at the post measurement just after the intervention. ] [ Designated as safety issue: Yes ]
  

• Peak oxygen consumption [ Time Frame: 1-2 day before the intervention and 1-2days after the 4 week intervention peak oxygen is measured ] [ Designated as safety issue: No ]
  Measurement of peak oxygen consumption during a ramp protocol on armergometer.
  
  
• Box and Block test [ Time Frame: 1-2 day before the intervention and 1-2days after the 4 week intervention the box and block test is performed ] [ Designated as safety issue: No ]
  
• Sit to stand test [ Time Frame: 1-2 day before the intervention and 1-2days after the 4 week intervention the sit to stand test is performed ] [ Designated as safety issue: No ]
  
• Handgrip test [ Time Frame: 1-2 day before the intervention and 1-2days after the 4 week intervention the handgrip test is performed ] [ Designated as safety issue: No ]
  
• Wheel-chair test [ Time Frame: 1-2 day before the intervention and 1-2days after the 4 week intervention the wheel-chair test is performed ] [ Designated as safety issue: No ]
  

For many years, patients with multiple sclerosis (MS) have been advised not to participate in physical exercise. This advice was given in part because some patients were reported to experience symptom instability during exercise as a consequence of increased body temperature. A further argument was that avoiding exercise would preserve energy and thereby result in less fatigue, leaving more energy for activities of daily living. During the last decade, it has been more common to recommend exercise for MS patients, because of its recently proven beneficial effects in these patients.

Resistance- and endurance training constitutes the two extremes of basic physical exercise. To gain insight into the effects of exercise it therefore makes sense to understand the extremes. In mild to moderately impaired MS patients endurance training is well tolerated and providing beneficial effects. However, this exercise modality has not yet been tested in severely disabled patients, and it is therefore unclear if endurance training is feasible and beneficial in these patients. The investigators have, therefore, designed a feasibility study evaluating the effects of 4 weeks of endurance training in severely disabled MS patients (Expanded Disability Status Scale score > 6).

Patients are inpatients at one of the national MS hospitals and endurance training is added to the usual care, and compared to usual care only (control group). Exercise frequency is 3 times per week, and intensity is controlled by HR measurements during exercise.