Apostolou G, Flouris AD, Kouidi E, Jamurtas AZ, Kenny GP, Kaltsatou A. Head and neck cooling enhance exercise tolerance in individuals with multiple sclerosis. Mult Scler Relat Disord. 2024 Nov;91:105833. doi: 10.1016/j.msard.2024.105833. Epub 2024 Aug 22. PMID: 39241465.

Highlights

• Head and neck cooling at 10 °C significantly increased exercise time in individuals with MS, demonstrating an improvement in exercise tolerance.

• The cooling intervention led to a substantial reduction in core and skin temperatures, indicating its effectiveness in mitigating thermal strain during exercise in MS patients.

• The head-and-neck cooling strategy, which effectively increased exercise tolerance and reduced core temperature, could be easily integrated into daily routines for individuals with MS to help mitigate Uthoff’s phenomenon symptoms.

Abstract

Background: Individuals with Multiple Sclerosis (MS) experience impairments in heat dissipation, compromising core temperature regulation during exercise.

Objective: To examine the efficacy of combined head-and-neck cooling as administered via a commercially available cooling cap and neck wrap in mitigating increases in core temperature during exercise.

Methods: On separate days, ten (7 females) adults (46.1 ± 11.6 years) with relapsing-remitting MS performed semi-recumbent cycling consisting of an incremental exercise bout to volitional fatigue in a temperate environment (23 °C, 50 % relative humidity) while undergoing head-and-neck cooling using a cooling cap and neck wrap maintained at 10 °C (COLD) or 24–26 °C (NEUTRAL). Prior to and following a 30-minute post-exercise recovery, functional capacity was assessed by a battery of tests consisting of a 2-minute walk test, Timed 25-Foot Walk test, sit-to-stand test, and Berg Balance Scale. Core (ingestible pill) and skin temperatures were recorded continuously. The level of fatigue was measured with questionnaires.

Results: The duration of the incremental exercise test increased with the application of COLD (28.4 ± 5.1 min) versus NEUTRAL water (vs 20.8 ± 5.1 min) (p = 0.001) and was paralleled by a significant reduction in body temperatures (∼1 °C, p < 0.05). The distance covered during the 2-min walk test performed after the incremental exercise test increased with the COLD (176.5 ± 0.6 m), relative to the NEUTRAL condition (147.7 ± 43.5 m) (p = 0.01). Fatigue levels did not change between conditions.

Conclusion: We show that head-and-neck cooling with cold water effectively enhances exercise tolerance and mitigates increases in core temperature during exercise in individuals with MS.

Keywords: Cooling, Functional capacity, Thermoregulation, Exercise, Quality of life, Chronic disease

Full Text Link:

https://www.msard-journal.com/article/S2211-0348(24)00410-3/abstract