Read Original Release

Claims but no context in summary of resistance training as a treatment for multiple sclerosis

Rating

3 Star

Resistance training may slow down the progression of multiple sclerosis

Our Review Summary

This news release from Aarhus University in Denmark claims that resistance training twice a week could protect the nervous system by minimizing brain shrinkage in multiple sclerosis (MS) patients, but offers no numbers backing the claims. The release summarizes a study published in the Multiple Sclerosis Journal on the protective effects of resistance training. It emphasizes to readers that resistance training should not replace medication, but instead supplement it. It also provides a study limitation — something not all news releases do. The release notes that it’s unclear whether the training could benefit all MS patients since this “has not been sufficiently tested in more severely affected patients.” The lead author further notes that he is not “recommending that all multiple sclerosis patients throw themselves into intensive physical training regimes without first seeking professional advice.”

We applaud the inclusion of this information. However, the main thing missing in this release is context. No numbers are given to back up its benefit claims. How much brain shrinkage was seen in patients undergoing resistance training compared to those who weren’t? And how much brain growth did researchers see in response to resistance training? Finally, does a change in cortical thickness translate to improvements in quality of life or cognitive abilities? Although thicker layers on a brain scan sounds good, it is how well a person feels and functions and how long they live that is more important.

 

Why This Matters

MS is the most common disabling neurologic disease of young people and affects approximately 400,000 people in the United States and 2.5 million worldwide. The disease can cause mild symptoms or be profoundly tragic. About half of people with MS experience cognitive impairments, according to the National Institute of Neurological Disorders and Stroke.

Patients with severe progressive MS often become wheelchair bound and suffer from dementia as their brains shrink over time. They become dependent on others and may end up in a nursing home if strong family support is not available.

There is no cure for MS. Most treatments are centered around managing symptoms, quality of life and assistive technology to help cope with disability. If there is a cost-effective, low-risk alternative for slowing MS progression, this would certainly be newsworthy for the public, especially if it is supported by medical evidence.

Criteria

Does the news release adequately discuss the costs of the intervention?

Not Satisfactory

Patients in the intervention group underwent resistance training twice a week for 6 months. The news release does not specify what types of exercises were included. It’s unclear whether the exercise program would require supervision by a physical therapist or whether it could be adapted to be done at home, perhaps with friend or family help. In any case, there are cost implications that should have been addressed.

Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

No numbers putting the benefits in context are given. Instead, the release uses broad, sweeping language to describe the benefits of resistance training. “The study shows that resistance training has a number of positive effects on the brain,” it states. Resistance training also “minimizes brain shrinkage in patients already receiving medication,” while some patients saw their brains “grow in response to training.”

In the original journal article, researchers state that 19 out of 74 cortical areas showed absolute increases in thickness, with a mean thickness being 0.03 mm, when comparing absolute values before and after resistance training of all participants. Researchers then compared these cortical areas to changes in muscle strength and motor function by looking at various physical and psychological parameters. Patients in the intervention group had increased knee muscle strength and performed better on a couple of motor tests (9-hole peg test and the timed 25-foot walk test) compared to those in the control group.

We wish the news release would have explained how these numbers might differ from what researchers would expect to see.

It is unclear from the journal article whether all patients displayed thicker brain cortexes after resistance training. We feel the news release could have included this information by following up with researchers. Therefore, we give it a Not Satisfactory rating here.

Does the news release adequately explain/quantify the harms of the intervention?

Not Satisfactory

The news release points out that MS patients were advised against exercise in the past for fear of exacerbating the condition. But only positive effects correlated with the study are addressed in the release, with no mention of potential harms. Weight training and other types of exercise have the potential to cause injury, which might be more likely in MS patients with reduced muscle function, impaired balance, or other issues. Consequently, we give the news release, a Not Satisfactory rating here.

Does the news release seem to grasp the quality of the evidence?

Satisfactory

The news release tells readers that 35 MS patients participated in the study, with half of the group receiving resistance training twice a week and the other half serving as controls with “no systematic training.” We don’t know what types of exercises were included in the training regimen, but the news release mentions this type of exercise has not been sufficiently tested in more severely affected MS patients. It also emphasizes to readers that resistance training should not replace medication and that more research is needed to discover why training has a “positive effect.”

In the original journal article, researchers point out that the patient population was “highly selected,” since all of them were being treated with the same drug — beta interferons. Patients then were randomized to either an immediate training or control group. Every training session — consisting of four lower and two upper body exercises — was separated by at least 48 hours from the previous exercise bout.

Other study limitations are the small sample size and relatively short study duration. As a result, this research is classified as a pilot/explorative study, something authors acknowledged in the published study.

We would have liked this information to be included in the news release, but since it did provide some other caveats to caution readers, we give it a Satisfactory rating here.

Does the news release commit disease-mongering?

Satisfactory

There is no disease mongering in the news release.

Does the news release identify funding sources & disclose conflicts of interest?

Satisfactory

The news release names the study’s funders in a sidebar on the EurekAlert! website as the Augustinus Foundation, Hestehandler Ole Jacobsens Mindelegat and Biogen Idec. We encourage news release writers to include funders in the text of the release as well.

Does the news release compare the new approach with existing alternatives?

Satisfactory

The news release mentions drugs as a treatment option for patients with MS. These include immunosuppressants, like corticosteroids to reduce nerve inflammation and beta interferons to reduce the frequency and severity of relapses. Plasma exchanges can also help patients who haven’t responded to steroids and whose symptoms are new and severe.

Other treatments options include physical therapy and muscle relaxants to help relieve MS signs and symptoms.

Although we would have liked more detail on established therapies, we feel the mention of medication was good enough for a Satisfactory rating here.

Does the news release establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The release provides too little information on what types of exercises are included in the training program and whether they require coaching and monitoring from a trained physical therapist. Is this training widely available for MS patients? We can’t know from this release.

Does the news release establish the true novelty of the approach?

Not Satisfactory

The news release makes it seem as if this study is the first to show the correlation between resistance training and slowing MS progression. The principal investigator of the study says in the lead quote, “…this study provides the first indications that physical exercise may protect the nervous system against the disease” and adds that this is “new and important knowledge.”

This comment is ambiguous and only half true. Iranian researchers found in 2015 that resistance training could slow MS disease progression and improve muscle strength and motor function. Another 2009 study by Spanish researchers showed resistance training could improve muscle function without injuries and “delay the functional deterioration in multiple sclerosis patients.”

What is new about this study, according to the original journal article, is that it’s the first randomized, controlled trial looking at “long-term exercise intervention” (24 weeks) with accompanying MRI images measuring brain degeneration and regeneration. They reported that patients engaging in resistance training also had thicker cerebral cortexes compared to controls.

We wish this information was more clearly and explicitly stated, which is why we give the news release a Not Satisfactory rating here.

Does the news release include unjustifiable, sensational language, including in the quotes of researchers?

Satisfactory

The news release does not include unjustifiable, sensational language.

Total Score: 5 of 10 Satisfactory

Comments

We Welcome Comments. But please note: We will delete comments left by anyone who doesn’t leave an actual first and last name and an actual email address.

We will delete comments that include personal attacks, unfounded allegations, unverified facts, product pitches, or profanity. We will also end any thread of repetitive comments. Comments should primarily discuss the quality (or lack thereof) in journalism or other media messages about health and medicine. This is not intended to be a forum for definitive discussions about medicine or science. Nor is it a forum to share your personal story about a disease or treatment -- your comment must relate to media messages about health care. If your comment doesn't adhere to these policies, we won't post it. Questions? Please see more on our comments policy.