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@ARTICLE{Joisten:143227,
      author       = {N. Joisten and A. Rademacher and W. Bloch and A. Schenk and
                      M. Oberste and U. Dalgas and D. Langdon and D. Caminada and
                      M.-T. Purde and R. Gonzenbach and J. Kool and P. Zimmer$^*$
                      and J. Bansi},
      title        = {{I}nfluence of different rehabilitative aerobic exercise
                      programs on (anti-) inflammatory immune signalling,
                      cognitive and functional capacity in persons with {MS} -
                      study protocol of a randomized controlled trial.},
      journal      = {BMC neurology},
      volume       = {19},
      number       = {1},
      issn         = {1471-2377},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2019-00826},
      pages        = {37},
      year         = {2019},
      abstract     = {Studies have shown positive effects of therapeutic exercise
                      on motor- and cognitive function as well as on psychosocial
                      outcomes in persons with multiple sclerosis (MS). A
                      reduction of inflammatory stress through physical exercise
                      has been suspected as one key mechanism, mediating the
                      positive effects of exercise in the context of MS. The
                      primary objective of this trial is to investigate the acute
                      and chronic effects of different exercise modalities on
                      (anti-)inflammatory immune signalling as well as on
                      cognitive and functional capacity in persons with MS.A two
                      armed single-blind randomized controlled design will
                      investigate 72 persons with relapsing remitting or secondary
                      progressive MS (EDSS 3.0-6.0), during 3 weeks of inpatient
                      rehabilitation. Participants will be randomized into either
                      a high-intensity interval training (HIIT) or a moderate
                      continuous training group; the latter represents the local
                      standard therapy (ST). Both groups will exercise 3x per
                      week. The HIIT group will perform 5 × 1.5-min
                      high-intensive exercise bouts at $95-100\%$ of their maximum
                      heart rate (HRmax) followed by active breaks of unloaded
                      pedalling $(60\%$ HRmax) for 2 min. In contrast, the ST
                      group will exercise for 24 min continuously at $65\%$ of
                      HRmax. The proportion of circulating regulatory T-cells will
                      be measured as primary outcome. Secondary outcomes comprise
                      numbers and proportions of further immune cells including
                      Th17-cells, soluble factors ((anti-) inflammatory cytokines,
                      tryptophan metabolites), endurance capacity, cognitive
                      performance, processing skills for activities of daily
                      living, fatigue, depression and healthcare-related quality
                      of life. Outcomes will be assessed before (T0) and after
                      (T3) the 3-week exercise intervention program. Blood samples
                      of T0 will be taken immediately before the first exercise
                      session. Additionally, blood samples for the soluble factors
                      will be collected immediately after (T1) and three hours
                      (T2) after the first exercise session of each group.This
                      study will be the first to investigate both acute and
                      chronic effects of aerobic exercise on immune function and
                      disease associated biomarkers in persons with MS. Combining
                      biological analyses with cognitive and functional capacity
                      assessments may contribute to a better understanding of
                      responses to rehabilitative training, needed to improve
                      exercise recommendations for persons with MS.This trial was
                      prospectively registered at ClinicalTrials.gov ( NCT03652519
                      ; 29 August 2018).},
      cin          = {C110},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30849952},
      pmc          = {pmc:PMC6407211},
      doi          = {10.1186/s12883-019-1267-9},
      url          = {https://inrepo02.dkfz.de/record/143227},
}