# High-intensity interval training improves bone remodeling, lipid profile, and physical function in multiple sclerosis patients

PMID: 39003295
Journal: Scientific reports
Published: 2024 Jun 29
Authors: Amato A, Proia P, Alioto A, Rossi C, Pagliaro A, Ragonese P, Schirò G, Salemi G, Caldarella R, Vasto S, Nowak R, Kostrzewa-Nowak D, Musumeci G, Baldassano S

## Question

Does 8 weeks of remotely supervised bodyweight HIIT improve bone remodeling markers, lipid profile, and physical function in people with multiple sclerosis?

## Summary

This small randomized trial tested 8 weeks of remotely supervised bodyweight HIIT in people with relapsing-remitting multiple sclerosis and mild disability. The exercise group trained live online three times per week for 30 minutes using 30-second exercise and 30-second active-rest circuits. HIIT improved timed-up-and-go, wall-squat performance, total cholesterol, LDL cholesterol, osteocalcin, and vitamin D, with no adverse events reported. The study is promising for remote bodyweight HIIT, but it included only 16 participants and the authors note baseline imbalance, online supervision limits, and no follow-up.

## Population

- Relapsing-remitting multiple sclerosis patients with minimal to mild disability.
- Sample size: 16
- Age: Exercise group 36.20 +/- 7.80 years; control 34.88 +/- 4.45 years; inclusion 20-55.
- Sex: Mixed; exact counts not extracted.
- Fitness level: No scheduled workout for at least one year; independently walking and able to perform motor tests.
- Health status: MS diagnosed by McDonald criteria, EDSS 1.5-3.5, no relapse in prior 12 months.

## Methodology

- Randomized controlled trial.
- 8 weeks
- Remote live online training supervised by kinesiologist and co-authors, with pre/post clinical assessments.
- Randomized and controlled study design.

## Protocol

- Remote bodyweight HIIT.
- Modality: Bodyweight circuit.
- Work intervals: 30 seconds.
- Recovery: 30 seconds active rest.
- Sets or repetitions: 4 sets, max repetitions per 30 seconds.
- Intensity: 85% age-predicted HRmax during exercise, 65% during active rest.
- Session duration: 30 minutes.
- Frequency: 3 days/week.
- Program length: 8 weeks.
- Progression: Upper-limb, lower-limb, and total-body sessions rotated across the week.
- Control.
- Modality: No scheduled exercise.
- Program length: 8 weeks.
- Progression: Control group maintained daily habits with no scheduled exercise or specific diet.

## Outcomes

### Lipid profile
Status: improved
Exercise group total cholesterol and LDL decreased significantly.

Total cholesterol 187.22 to 173.44 mg/dL p=0.045; LDL 108 to 95.02 mg/dL p=0.022.

### Bone markers
Status: improved
Exercise group osteocalcin and vitamin D increased; PTH and beta-CrossLaps did not significantly change.

Osteocalcin 20.88 to 23.66 microg/L p=0.025; 25-OH vitamin D 21.11 to 27.66 microg/L p=0.043.

### Physical function
Status: improved
Exercise group improved timed-up-and-go and wall-squat performance.

TUG 7.65 to 6.34 seconds p=0.001; wall squat 27.18 to 41.68 seconds p=0.002.

### Safety/adherence
Status: mixed
No adverse events occurred; exercise attendance was 71.54%.

All 16 participants completed study phases; exercise group adherence to scheduled sessions 71.54%.

## Practical Insights

- A 30/30 bodyweight format is a useful app-programming template, especially for remote or home training.
- Small supports such as a chair or table can make HIIT more accessible.
- Remote HIIT needs camera, form, and safety guidance if used in clinical or limited-mobility populations.

## Limitations

- Very small sample size.
- Baseline imbalance after stratified randomization.
- Online format limited socialization and correction of errors.
- No follow-up.
- Mild MS only.

## Safety And Adherence

- No adverse events occurred during training.
- Remote supervision can miss execution errors due to internet interruptions or poor framing.
- Participants had mild disability and no recent relapse.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/39003295/) (pubmed)
- [DOI](https://doi.org/10.1038/s41598-024-66015-y) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246443/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.