Multiple Sclerosis Clinical Trial
Official title:
The Impact of Carnosine Loading and Rehabilitation Therapy on Exercise Capacity in Multiple Sclerosis.
Increasing evidence favours exercise therapy as an efficient tool to counteract inactivity related secondary symptoms in MS. Furthermore, exercise therapy may affect MS-associated muscle contractile and energy supply dysfunctions. So far, low to moderate intensity exercise rehabilitation has shown to induce small but consistent improvements in several functional parameters. High intensity exercise training in MS seems to further improve this. However, although results are promising, impairments in both muscle contraction and energy supply probably attenuate therapy outcome. In keeping with the above described physiological role of skeletal muscle carnosine and because muscle carnosine content may be lower in MS, the primary aim of the present project is to investigate whether carnosine loading improves exercise therapy outcome (exercise capacity, body composition) and performance in MS. If the latter hypothesis can be confirmed, muscle carnosine loading could be a novel intervention to improve exercise capacity and muscle function in this population.
Pilot data from the (co-)applicants' laboratories suggest that EAE rats (animal MS model) and
MS-patients suffer from significantly reduced muscle carnosine levels compared to healthy
counterparts. The potential of β-alanine supplementation to elevate muscle carnosine content
has been shown in healthy volunteers. Furthermore, the investigators have recently
investigated β-alanine and carnosine supplementation in EAE animals. In MS, this has not been
investigated yet. Therefore, the researchers' next step is to investigate the impact of
β-alanine intake on exercise performance in MS patients. The investigators hypothesize that
oral β-alanine supplementation improves exercise therapy outcomes in MS patients.
So far, it is clear that β-alanine intake enhances exercise capacity of untrained, trained
and aged individuals by improving contractile properties, maintaining higher intracellular
energy levels and optimizing training adaptations. Because early fatigue of contracting
musculature during rehabilitation is the predominant cause of exercise cessation, postponing
exercise-induced fatigue by β-alanine supplementation will be clinically very relevant
(improving exercise therapy efficiency). Consequently, the investigators aim to research the
ergogenic potential of β-alanine intake in MS rehabilitation and hypothesize that β-alanine
supplementation optimizes exercise therapy outcome (exercise capacity, muscle contractile
characteristics) in this population.
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