Multiple Sclerosis and Related Disorders · Feb 10, 2026

Cardiorespiratory response to different aerobic exercise modalities in people with advanced multiple sclerosis

By Edwards T, Chaves AR, Awadia Z et al.

BACKGROUND: People with multiple sclerosis (MS) experience physiological deconditioning, notably the loss of cardiorespiratory fitness (CRF). Exercise training is effective for improving CRF in people with mild-to-moderate MS; however, the effect of exercise on CRF in people with advanced MS remains unclear. The objective of this repeated-measures study of acute exercise was to characterize the cardiorespiratory response of people with advanced MS (i.e., wheelchair users) to three aerobic exercise modalities. METHODS: Eighteen people with advanced MS (n = 15 female; mean age = 60.7 ± 11.1 years) completed three 15-minute submaximal (prescribed Rating of Perceived Exertion [RPE] = 12-13) exercise bouts using an arm cycle ergometer (ACE), a recumbent stepper (RS), and a functional electrical stimulation (FES) leg cycle. The exercise response was recorded as oxygen consumption (V̇O₂), heart rate (HR), work rate (WR), respiratory exchange ratio (RER), and RPE. RESULTS: All modalities elicited a cardiorespiratory response that corresponded with moderate-to-vigorous intensity exercise (58-68 %V̇O2peak; 79-88 %HRpeak), and there was no difference in RPE across modalities (p = 0.317). Mean submaximal V̇O₂ (mL/min, mL/(kg.min)⁻¹, and %V̇O2peak), HR (bpm and %HRpeak), WR (Watts and %WRpeak), and RER were all lower in response to FES cycling compared to ACE (all p ≤ 0.042) and RS (all p ≤ 0.036) exercise. There were no differences between ACE and RS exercise. CONCLUSIONS: The current findings support the potential for improving CRF through aerobic exercise in people with advanced MS. At a matched RPE, FES cycling may provide a less demanding aerobic stimulus.

doi.org/10.1016/j.msard.2026.107065PubMed 41724139Interventions