BACKGROUND: The influences of exercising on cytokine response, fatigue and cardiorespiratory values are important aspects of rehabilitation in MSers. Exercise performed within these programs is often practised in water but the effects of immersion on MSers have not been systematically investigated.
OBJECTIVE: The objective of this study is to determine differences in cytokine and neurotrophin concentrations, fatigue and cardiorespiratory values in response to 3 week endurance training conducted on a cycle ergometer or an aquatic bike.
METHODS: A randomized controlled clinical trial was conducted in 60 MSers (EDSS range 1.0-6.5). Resting serum levels of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), Interleukin-6, soluble receptor of IL-6 and tumor necrosis factor alpha, and concentrations in response to cardiopulmonary exercise test (CPET), fatigue and cardiorespiratory values were determined at entry and discharge. Subjects performed daily 30 minute training at 60% of VO(2)max.
RESULTS: Cytokines and neurotrophins showed no significant differences between groups over the training intervention. Within the water group BDNF resting and post-CPET concentrations (p<0.05) showed a significant increase and NGF tended to increase after the training intervention. Short-term effects on BDNF (CEPT) tended to increase at the start and significantly thereafter (p<0.05). No changes occurred in the land group. Other cytokines and fatigue scores remained unchanged over the training period. Cardiorespiratory values improved significantly over time within both groups.
CONCLUSION: This study indicates that aquatic training activates BDNF regulation and can be an effective training method during rehabilitation in MSers.
“Brain-derived neurotrophic factor (BDNF) is one of the good cytokines that is a nerve survival factor and may rise after training exercise in the water. Exercise also releases endorphins within the brain that have a mood ealevating effect. Exercise also increases your aerobic capacity and when done properly will reduce physical fatigue. The metabolic benefits of exercise in relation to weight loss and improved glucose metabolism is another reason to participate if you can. If you are unsure about what to do ask your MSologist to refer you to physio for an assessment.”
Whilst I'm a big believer in the value of exercise for MSers, I don't get this study. Exercise in water produces increased BDNF but not exercise on land? What possible logical basis could there be for that to be true? Surely, either exercise produces BFNF or, much less likely, being in the water produces it but it makes no sense for exercise specifically in water to be significant?
It may be that you are able to exercise more in water. Water may blunt the rise in body temperature, etc. I agree it makes no sense, but sometimes observations like this lead one to ask the right questions. I think the observation needs to be reproduced and if validated a reason for the observation needs to be sought!
I am lucky enough to have a facility for hydrotherapy near home. I have a weekly one-to-one session with the physio in the water with me. She has me doing strengthening exercises, tests limbs and has me doing movements I couldn't do on land. Says it's important to keep muscle memory going. Also in warm water she can do amazing stretches on my legs and trunk – all very helpful. There's also equipment such as flippers, dumbells and weights. For all this to work, the water has to be very warm (there's a temperature range set for any pool to qualify as a hydro pool) – it's like going in to a warm bath. The muscles relax so the physio can really work them. It's physio with legs! I also swim at a regular pool and can exercise four or five times as long as I can in the gym. Because you're not working against gravity, there is far less effort required and there's not the same risk of muscle strain. But hydrotherapy is BRILLIANT – a pity that's it's not more widely available.