Introduction: Combined physical-cognitive training is one of the effective interventions for patients with Multiple Sclerosis (MS), which may affect different aspects of the disease. The present study aimed to investigate changes in patients with MS by performing combined aerobic-cognitive training (Brythonic) and conventional aerobic training (Aerotonic).
Methodology: Thirty patients (22 women and 8 men) with Relapsing-Remitting and Expanded Disability Status Scale (EDSS) less than four (Mean ± SD; age, 36.66±9.36 years; height,164.5±6.3 cm; weight, 65.43±9.80 kg; body mass index, 24.02±3.02 kg/m2) were randomly divided into 3 equal groups of Brythonic training, Aerotonic training, and control. Subjects in Brythonic and Aerotonic groups performed 10 weeks of home-based online training, two sessions per week. The activity of the Brythonic group was to perform motivational words with aerobic movements in each session. During ten weeks, these words formed a complete sentence with a positive meaning. In the Aerotonic group, the same aerobic movements as the Brythonic group were performed, with the difference that there was no cognitive load. The control group did not have any training activities. In the pre-test and also after ten weeks of online training at home, the values of Interleukin 17 (IL17), Interleukin 4 (IL4), and Interleukin 17 to Interleukin 4 ratio (IL4/IL17), Time Up and Go (TUG) and Six-Minute Walk Test (6MWT) were evaluated.
Results: Interleukin 17 showed a significant decrease in the Brythonic group compared to the control group (P>0.0001), also the intra-group decrease of this factor in the Brythonic group was significant at the beginning and end of the training. Interleukin 4, although there was no significant difference between any of the groups, but its decrease in the control group is significant. Regarding the ratio of Interleukin 17 to Interleukin 4, there was a significant decrease within the group at the beginning and end of the training in the Brythonic group. TUG and 6MWT variables substantially differed in training groups compared to the control.
Conclusion: This study concluded that performing any aerobic activity, even with moderate intensity, can improve some symptoms of MS. Similarly, adding cognitive load to this aerobic activity can cause a more significant effect, specifically on inflammatory factors.