The Effect of High-Intensity Interval Training Type on Body Fat Percentage, Fat and Fat-Free Mass: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) compared body compositional changes, including fat mass (FM), body fat percentage (BF%), and fat-free mass (FFM), between different types of high-intensity interval training (HIIT) (cycling vs. overground running vs. treadmill running) as well as to a control (i.e., no exercise) condition. Meta-analyses were carried out using a random-effects model. The I2 index was used to assess the heterogeneity of RCTs. Thirty-six RCTs lasting between 3 to 15 weeks were included in the current systematic review and meta-analysis. RCTs that examined the effect of HIIT type on FM, BF%, and FFM were sourced from online databases including PubMed, Scopus, Web of Science, and Google Scholar up to 21 June 2022. HIIT (all modalities combined) induced a significant reduction in FM (weighted mean difference [WMD]: -1.86 kg, 95% CI: -2.55 to -1.18, p = 0.001) despite a medium between-study heterogeneity (I2 = 63.3, p = 0.001). Subgroup analyses revealed cycling and overground running reduced FM (WMD: -1.72 kg, 95% CI: -2.41 to -1.30, p = 0.001 and WMD: -4.25 kg, 95% CI: -5.90 to -2.61, p = 0.001, respectively); however, there was no change with treadmill running (WMD: -1.10 kg, 95% CI: -2.82 to 0.62, p = 0.210). There was a significant reduction in BF% with HIIT (all modalities combined) compared to control (WMD: -1.53%, 95% CI: -2.13, -0.92, p = 0.001). All forms of HIIT also decreased BF%; however, overground running induced the largest overall effect (WMD: -2.80%, 95% CI: -3.89 to -1.71, p = 0.001). All types of HIIT combined also induced an overall significant improvement in FFM (WMD: 0.51 kg, 95% CI: 0.06 to 0.95, p = 0.025); however, only cycling interventions resulted in a significant increase in FFM compared to other exercise modalities (WMD: 0.63 kg, 95% CI: 0.17 to 1.09, p = 0.007). Additional subgroup analyses suggest that training for more than 8 weeks, at least 3 sessions per week, with work intervals less than 60 s duration and separated by ≤90 s active recovery are more effective for eliciting favorable body composition changes. Results from this meta-analysis demonstrate favorable body composition outcomes following HIIT (all modalities combined) with overall reductions in BF% and FM and improved FFM observed. Overall, cycling-based HIIT may confer the greatest effects on body composition due to its ability to reduce BF% and FM while increasing FFM.

Spirulina supplementation during gradual weight loss in competitive wrestlers.

We aimed to assess the effects of spirulina supplementation during gradual weight loss on serum concentrations of follistatin (FST), myostatin (MST), insulin-like growth factor 1 (IGF-1), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and body composition in competitive wrestlers. Forty competitive wrestlers (age: 22 (sem 2) years) were randomly assigned to one of two groups: gradual weight loss + spirulina (SP; n 20) or gradual weight loss + placebo (PL; n 20). Subjects in both groups lost weight according to a designed diet over 12 d and were required to reduce baseline body mass (BM) by 4%. Subjects in the SP group received two tablets of spirulina, while subjects in the PL received two tablets of placebo before each meal. Concentrations of mentioned serum markers and body composition were measured before and after the interventions. BM (SP = -3·1 kg and PL = -2·9 kg), body fat percentage (BFP) (SP = -2·1 % and PL = -0·6 %), fat mass (FM) (SP = -2·2 kg and PL = -0·9 kg) and skeletal muscle mass (SP = -1·4 kg and PL = -1·5 kg) significantly decreased in both groups (P < 0·05). The changes in BFP and FM were significantly greater in SP compared with the PL group (P < 0·001). Additionally, MST (SP = -0·1 ng/ml), AST (SP = -2·1 u/l) and ALT (SP = -2·7 u/l) concentrations significantly diminished in SP group (P = 0·005), while FST (PL = -0·1 ng/ml) and IGF-1 (PL = -2·6 ng/ml) concentrations significantly decreased in PL group (P < 0·05). Spirulina supplementation during gradual weight loss is beneficial in reducing BFP, FM, MST and liver enzymes while maintaining IGF-1 and FST concentrations in competitive wrestlers.

Home-based exercise training influences gut bacterial levels in multiple sclerosis.

BACKGROUND: Multiple sclerosis is associated with gut microbiome alterations. The current study aimed to investigate the effect of home-based exercise on gut bacteria in people with multiple sclerosis (MS). We also examined the association of exercise-induced gut bacterial modulation with circulating levels of inflammatory and anti-inflammatory cytokines. MATERIALS AND METHODS: Forty-two people with MS (female/male: 31/11, expanded disability scale status <5) participated in this study and were divided into two groups: 6 months of home-based exercise (5 sessions per week) and controls. Before and after the intervention, the following parameters were assessed: gut microbiota, including faecalibacterium prausnitzii, akkermansia muciniphila, prevotella and bacteroides counts; cytokine levels including interleukin (IL)-10 and tumor necrosis factor-alpha (TNF-α); and psychosocial factors including anxiety, depression, and fatigue. RESULTS: Home-based exercise significantly increased prevotella counts, and decreased akkermansia muciniphila counts (p < 0.05); however, there were no significant effects on faecalibacterium prausnitzii and bacteroides counts (p > 0.05). There were no significant effects of home-based exercise on circulating cytokine levels (p > 0.05). Moreover, home-based exercise was associated with significant improvements in anxiety and depression (p < 0.05); however, fatigue revealed no significant change (p > 0.05). Akkermansia muciniphila, prevotella and bacteroides count changes in response to the intervention were correlated with changes in IL-10 (r = -0.052, r = 0.67, and r = -0.55, respectively). CONCLUSION: In general, our data revealed the effect of exercise on gut bacteria, especially prevotella, and akkermansia muciniphila counts, which can probably have a beneficial effect on MS disease pathology and course; however, the lack of changes in cytokines following exercise suggests the possible role of mechanisms other than modulation of circulating IL-10 and TNF- α levels.

Home-Based Exercise Training in Multiple Sclerosis: A Systematic Review with Implications for Future Research.

BACKGROUND: Substantial evidence supports the benefits of supervised exercise training (ET) in people with multiple sclerosis (MS). However, there are limitations such as transportation problems preventing physical activity for some people with MS. One opportunity for increasing physical activity participant in people with MS is home-based exercise training (HBET), yet we are unaware of a systematic review of HBET in people with MS. We undertook a systematic review for enhancing the knowledge about HBET in people with MS. METHODS: To identify eligible studies, we included the medical subject headings (MeSH) keywords including 'multiple sclerosis' OR 'MS' OR 'degenerative nerve disease' AND 'home-based exercise' OR 'home-based training' OR 'home-based balance training' OR 'home-based rehabilitation' OR 'physical telerehabilitation' OR 'home-based walking' OR 'home-based step training.' Studies were included in this review that examined the effect of HBET in people with MS, were written in English, and available in full-text. RESULTS: According to inclusion and exclusion criteria, 24 studies were judged eligible to be included in this systematic review. The results indicated that a total number of 10 studies had mainly implemented combined ET interventions. Balance and aerobic ET had been included in 5 studies. Three studies had further administered resistance ET interventions and one study had applied exergaming. Moreover, 13 studies had focused on the effects of ET on physical fitness, one article had reflected on the impact of ET on fatigue, and nine cases had included fatigue, quality of life, and fitness as outcome measures. CONCLUSIONS: Home-based ET, 2-7 times per week, is beneficial, feasible, and safe in people with MS. Nevertheless, there were notable limitations, including (a) adherence to interventions, which needs to be addressed in future studies, and (b) disability-related outcomes which should be considered in future HBET studies.

Physical activity may contribute to brain health in multiple sclerosis: An MR volumetric and spectroscopy study.

BACKGROUND AND PURPOSE: Physical activity may represent a disease-modifying therapy in persons with multiple sclerosis (pwMS). To date, there is limited research regarding mechanisms based on brain imaging for understanding the beneficial effects of physical activity in pwMS. This study examined the relationship between physical activity levels and thalamic and hippocampal volumes and brain metabolism in pwMS. METHODS: The sample of 52 pwMS (37.3 ± 9.6 years of age; 35 females, 17 males) underwent a combination of volumetric magnetic resonance imaging and magnetic resonance spectroscopy. Current and lifetime physical activity were assessed using actigraphy and the adapted version of the Historical Activity Questionnaire, respectively. RESULTS: Positive associations were observed between both actigraphy and self-reported levels of moderate-to-vigorous physical activity (MVPA) and thalamic and hippocampal volumes. Regarding brain metabolism, actigraphy and self-reported levels of MVPA were positively associated with higher hippocampal and thalamic levels of N-acetylaspartate/creatine ratio (NAA/Cr: marker of neural integrity and cell energy state). CONCLUSIONS: This study provides novel evidence for a positive association between physical activity and thalamic and hippocampal volume and metabolism in pwMS. These findings support the hypothesis that physical activity, particularly MVPA, may serve as a disease-modifying treatment by improving brain health in pwMS.

Exercise training and cognitive performance in persons with multiple sclerosis: A systematic review and multilevel meta-analysis of clinical trials.

BACKGROUND: Cognitive impairment is common, debilitating, and poorly managed in persons with multiple sclerosis (pwMS). Exercise training might have positive effects on cognitive performance in pwMS, yet the overall magnitude, heterogeneity, and potential moderators remain unclear. OBJECTIVE: This three-level meta-analysis aims to identify the effects of exercise training and those of exercise modalities on global and domain-specific cognitive performance in pwMS. METHODS: MEDLINE, PsycInfo, SportDiscus, CENTRAL, and EMBASE were screened for randomized and non-randomized clinical trials from inception to 27 January 2020, yielding 3091 articles. Based on titles and abstracts, 75 articles remained in the selection process. After full-text evaluation, 13 studies were finally selected (PROSPERO pre-registered). RESULTS: The pooled effect of exercise training on the global cognitive performance was null (g = 0.04, 95% confidence interval (CI): -0.11 to 0.18) and no significant differences were displayed among domains. Heterogeneity within studies was null (I(2)2= 0.0%) and between studies was low (I(3)2= 25.1%). None of the moderators (exercise modalities, age, Expanded Disability Status Scale (EDSS), supervision, cognitive domains) reached significance. However, the exercise volume explained most of the overall heterogeneity (slope = 4.651 × 10-5, R(2)2 = 100%, R(3)2 = 52.34%). CONCLUSION: These results do not support the efficacy of exercise training on global or domain-specific cognitive performance in pwMS. Future studies are needed to determine whether higher training dose are beneficial.

Effect of combined exercise training on pentraxins and pro- inflammatory cytokines in people with multiple sclerosis as a function of disability status.

OBJECTIVES: There is some evidence for beneficial effects of exercise on cytokines in people with multiple sclerosis (MS), but it is unclear if such effects differ by disability status (i.e., stage of the disease). This study investigated the effect of combined exercise training on pentraxins and pro- inflammatory cytokines in people with multiple sclerosis as a function of disability status. METHODS: This randomized control trial included 94 women with MS who were randomly assigned into exercise or control conditions with randomization stratified by Expanded Disability Status Scale (EDSS) scores of low (EDSS < 4.5), moderate (4.5 ≤ EDSS ≤ 6), or high (EDSS ≥ 6.5) disability. The exercise program lasted 12 weeks and comprised resistance, endurance, Pilates, balance and stretch exercises performed? days/week; the control condition involved a waitlist control. We measured resting levels of inflammatory factors, functional capacity, and lipid profile before and after the 12-week intervention period. RESULTS: Combined exercise training significantly decreased hs-CRP (p = 0.029) and IL-6 (p = 0.001) and increased PTX-3 (p = 0.001) and IFN-Æ´ (p = 0.001), but there was no significant change in Fibrin D-dimer (FDD) (p = 0.876) compared with control, and those effects were independent of disability status. 1RM for lat pull-down, knee extension, and seated row and 6MWT (i.e., walking further) significantly increased and TUG performance significantly decreased (i.e., faster performance) (all, p < 0.001) after combined exercise compared with control, and this too was independent of disability status. CONCLUSIONS: Exercise may stimulate anti-inflammatory effects in MS, and this is generally not influenced by disability status. Exercise training may be an adjuvant for disease-modifying therapy among people with MS, and such effects might not be moderated by disability status.

Exercise improves neurotrophins in multiple sclerosis independent of disability status.

BACKGROUND: To date, studies examining the effect of exercise on neurotrophic factors in MS are contradictory, and this may be explained, in part, by moderators such as disability status. To investigating the effect of a 12-week (3sessions/week) supervised multimodal exercise program on neurotrophic factors levels. METHODS: Ninety four women with MS were randomly assigned into exercise or control conditions with randomization stratified by Expanded Disability Status Scale (EDSS) scores of low (EDSS< 4.5), moderate (4.5 ≤EDSS≤ 6), or high (EDSS≥ 6.5) disability. The exercise program comprised resistance, endurance, Pilates, balance and stretch exercises. Resting level of neurotrophic factors, aerobic capacity, one-repetition maximum, and physiological cost index (PCI) were evaluated before and after the intervention period. RESULTS: Exercise training improved brain-derived neurotrophic factor (BDNF), neurotrophin (NT)-3, and NT-4/5 levels. The effect of exercise on NT-3 was dependent on disability status such that exercise groups with low and high disability had more pronounced changes compared with other condition. There were no exercise effects on ciliary neurotrophic factor (CNTF) and glial cell-derived neurotrophic factor (GDNF). Aerobic capacity and one-repetition maximum, but not PCI, were improved with exercise independent of disability status. CONCLUSIONS: Exercise can stimulate neurotrophic production and secretion, and this is generally not influenced by disability status. Exercise training may be an adjuvant for disease-modifying therapy among people with MS, and its effect may not be moderated by disability status.

Skeletal Muscle Hypertrophy, Insulin-like Growth Factor 1, Myostatin and Follistatin in Healthy and Sarcopenic Elderly Men: The Effect of Whole-body Resistance Training.

BACKGROUND: Sarcopenia describes the inevitable deterioration in muscle mass and strength that accompanies biological aging. The purpose of this study was to investigate the effects of resistance training (RT) on quadriceps hypertrophy and related biochemistry in sarcopenic and healthy elderly men. METHODS: A total of 31 elderly men (55-70 years old) were classified as sarcopenic and nonsarcopenic and were divided into two groups. Both groups participated in a progressive RT program for 8 weeks. RESULTS: Data indicated that the strength in the sarcopenic group increased more than the healthy group (P < 0.05). Quadriceps cross-sectional area also increased more in the healthy group (P < 0.05). Myostatin concentration decreased in both groups after training (P < 0.05). Follistatin and testosterone increased in the healthy group; in contrast, only testosterone increased in the sarcopenic group after training (P < 0.05). CONCLUSIONS: The findings from this study suggest that RT improves muscle cross-sectional area and biomarker-related muscle loss in both healthy and sarcopenic elderly men. The findings also demonstrate that growth factor profiles at baseline and changes in testosterone levels play an important role in muscle hypertrophy observed in both groups.

Weight control and physical exercise in people with multiple sclerosis: Current knowledge and future perspectives.

There is extensive data supporting a high prevalence of both overweight and obesity status in people with multiple sclerosis, and increases in body mass index has been associated with an increased risk of multiple sclerosis. Body composition may influence the course, treatment and management of multiple sclerosis. One proposed strategy for managing overweight and obesity status and associated secondary effects in people with multiple sclerosis involves increasing the levels of physical activity. In fact, increased levels of physical activity affect various physiological (endurance capacity, strength, balance) and biological processes (fat oxidation, insulin sensitivity, anti-inflammation, neurotrophic factors) which are known to be dysfunctional in multiple sclerosis and which may worsen with increases in obesity. When designing personalized exercise programs it should be kept in mind that current exercise recommendations for people with multiple sclerosis should exceed energy expenditure recommendations to efficiently counteract weight gain. Therefore, it is necessary to consider body composition as a primary endpoint in experimental studies. In addition, designing guidelines for weight control or weight loss in people MS is needed. The most comprehensive weight management guidelines are outlined in the American College of Sports Medicine Position Statement, which recommends between 150-250 min per week of moderate-intensity physical activity for preventing weight gain, and between 225-420 min per week of moderate-intensity physical activity for weight loss. These recommendations seem applicable for people with multiple sclerosis.

Reliability and Validity of a Novel Futsal Special Performance Test Designed to Measure Skills and Anaerobic Performance.

PURPOSE: To examine the validity and reliability of a novel futsal special performance test (FSPT) as a measure of futsal performance and skills. METHODS: Thirty-six futsal players with different levels of experience were recruited and divided into 2 groups (elite and nonelite). Players participated in 4 sessions (at least 7 d apart): (1) familiarization session, (2) anaerobic power (Wingate test), (3) FSPT trial 1, and (4) FSPT trial 2. The FSPT was carried out on a futsal court (wooden sprung floor) and skills such as dribbling, rotation, long and short passing, and shooting were examined. Content validity was assessed by 6 experienced futsal coaches and instructors. RESULTS: There was a significant correlation between FSPT and various aspects of anaerobic power (r = .5-.91; P ≤ .001). Moreover, significant large correlations were observed between test and retest of FSPT (r = .77; 95% confidence interval [CI], .56-.98; P ≤ .001). All instructors and coaches confirmed the content validity. There was high interrater reliability of the FSPT (r = .89; 95% CI, .85-.93; P < .001). FSPT total time (P = .001), penalty time (P = .022), and performance time (P = .001) were superior in elite relative to nonelite players. Anaerobic power was greater in elite players (P < .001). CONCLUSION: The results support the use of the FSPT to assess futsal players' performance in conjunction with skill and anaerobic fitness.

Effect of Short-Term Interval Exercise Training on Fatigue, Depression, and Fitness in Normal Weight vs. Overweight Person With Multiple Sclerosis.

CONTEXT: Excessive weight is a health problem that can exacerbate multiple sclerosis (MS) symptoms and its associated comorbidities such as depression and fatigue. In addition, weight may be a moderator of exercise effects on depression and fatigue symptoms. OBJECTIVE: This study aimed to investigate the effects of exercise training on fatigue and depression in normal and overweight individuals with MS. METHODS: Sixty-six persons with MS were randomly assigned into an exercise or control condition based on body weight status (overweight vs. normal weight). The exercise conditions involved 8-weeks of interval exercise at 60%-75% Wattpeak, while the control condition did not involve any exercise. Fatigue, depression, aerobic capacity, time up and go (TUG) and body mass index were measured before and following the 8-week period. RESULTS: There were no significant relationship's revealed for weight status interactions for any of the variables examined. There were significant condition main effects for fatigue, depression, aerobic capacity and TUG, and significant improvements were noted for the exercise conditions, but not in the non-exercising control group. CONCLUSION: The results from this study confirm that exercise is an effective therapeutic intervention for improving fatigue, depression and functional parameters, independent of initial weight status, in persons with MS.

Effects of different dosages of caffeine administration on wrestling performance during a simulated tournament.

The aim of the present study was to investigate the effects of different forms of caffeine administration on physical performance during a simulated wrestling tournament. In a double-blind and randomized experiment, twelve male freestyle wrestlers competed in a simulated wrestling tournament (5 wrestling matches consisting of 2 × 3-min wrestling rounds) following the ingestion of: a placebo, a high-dose of caffeine (10 mg/kg), a moderate-dose caffeine (4 mg/kg), a repeated-dose caffeine (2 mg/kg before each match to a total of 10 mg/kg) or a selective caffeine administration based on performance decrement previously measured (6.16 ± 1.58 mg/kg). The Pittsburgh Wrestling Performance Test (PWPT) was measured before each match to assess physical performance. In comparison to the placebo, the high dose of caffeine only reduced PWPT time before the first match (56.8 ± 2.0 vs. 52.9 ± 1.8 s; p < .05). The moderate dose of caffeine did not affect PWPT performance during the tournament. Both, the repeated dose and the selective administration of caffeine reduced PWPT time with respect to the placebo in the third (66.7 ± 1.8 vs. 63.1 ± 1.4 s; p < .05) and fourth matches (72.3 ± 2.4 vs. 65.9 ± 1.3 s; p < .05). However, only the selective dose of caffeine reduced PWPT time before the fifth match (62.7 ± 3.0 vs. 56.3 ± 2.0; p < .05). The dosage and administration of caffeine affect the ergogenic effects obtained following the ingestion of this substance. An individualized protocol to provide caffeine when physical performance is expected to be reduced might improve wrestling performance during the latter stages of a tournament.

Effects of exercise training on cytokines and adipokines in multiple Sclerosis: A systematic review.

BACKGROUND: Physical activity, particularly exercise training, is an evidence-based approach for managing symptoms, restoring function and improving overall wellness in people with multiple sclerosis (MS). Several recent studies have argued for a potential disease modifying effect of exercise in people with MS, and among the potential mediating mechanisms are exercise training effects on both cytokines and adipokines. The objectives of this study were to perform a systematic review of exercise training effects on cytokine and adipokine profiles in persons with MS. METHODS: We conducted open-dated searches of PubMed, Cochrane Library, EMBASE and PEDro using the terms 'Multiple sclerosis' or 'MS' AND 'exercise' OR 'training' OR 'physical activity' AND 'cytokine' OR 'inflammatory' OR 'immune' OR 'adipokine'. Included studies were written in English; comprised of humans with MS, and evaluated the effects of regular physical activity or exercise on pro-inflammatory, anti-inflammatory cytokines or adipokines. Two authors independently scanned titles and abstracts, and read the studies included. All studies were rated on the PEDro scale and further classified based on American Academy of Neurology criteria. RESULTS: Twelve studies were included of which 10 studies focused on cytokines, 1 study focused on adipokines, and 1 study included both cytokines and adipokines. The selected studies included 3 Class I studies, 7 Class II studies, and 2 Class IV studies and had average PEDro scores of 6.9 ±â€¯1.6. Studies included endurance (n = 5), resistance (n = 3), combined (n = 3), and vibration (n = 1) training. Overall, there is a general lack of standardization of procedures across studies and inconsistent evidence for the effects of physical activity and exercise on cytokine and adipokine profiles in MS, with a general pattern indicating a lack of effect. CONCLUSION: Research regarding the effects of exercise training on cytokines and adipokines in MS is in its infancy, but exercise represents an adjuvant therapy in MS, and future studies are essential for clarifying the role of exercise on cytokines and adipokines in MS.

Exercise-induced changes in neurotrophic factors and markers of blood-brain barrier permeability are moderated by weight status in multiple sclerosis.

Blood-brain barrier (BBB) and neurotrophic factors seemingly have an important role in multiple sclerosis pathology. Physical activity may influence blood-brain barrier function and levels of neurotrophic factors, and such effects might be moderated by body weight status. This study investigated the effect of exercise training on markers of blood-brain barrier permeability and neurotrophic factors as a function of weight status in multiple sclerosis patients. Sixty three persons with relapsing remitting multiple sclerosis who were normal weight (n: 33) or overweight (n: 33) were randomly assigned into groups of exercise (normal weight training, n: 18; overweight training group, n: 18) or no exercise (normal weight control, n: 15; overweight control group, n: 15). The intervention consisted of 8 weeks (3 days per week) of cycling undertaken at 60-70% peak power. Resting blood concentrations of s100 calcium-binding protein B (s100b) and neuron-specific enolase as BBB permeability markers, neurotrophic factors and cytokines (Interleukin-10 and tumor necrosis factor alpha) were evaluated before and after the intervention. There were significant weight, training, and interaction effects on brain-derived neurotrophic factor and platelet-derived growth factor; however, ciliary neurotrophic factor and nerve growth factor did not demonstrate any effect. Brain-derived neurotrophic factor and platelet-derived growth factor were significantly increased from pre-post in normal weight exercise. Significant weight, training, and interaction effects were found for s100b. In detail, s100b was significantly increased from pre-post in normal weight exercise. In contrast, neuron-specific enolase and cytokines did not demonstrate any effect. Generally, Exercise training may alter markers of BBB permeability and neurotrophic factor status in normal weight persons with multiple sclerosis; however, overweight participants may be more resistant to these effects of exercise.

Acute responses of cytokines and adipokines to aerobic exercise in relapsing vs. remitting women with multiple sclerosis.

OBJECTIVE: To examine the acute effect of exercise on cytokines and adipokines during relapse and the remitting phase of multiple sclerosis (MS). METHODS: Thirty women with MS in the relapsing or remitting phase were matched with fifteen healthy controls. Participants performed a single-bout of aerobic exercise at 60-70% maximal heart rate. Furthermore, five women in the relapsing phase were enrolled (control relapse) and did not receive any intervention. Blood samples were taken before, immediately after, 1-h and 6-h after the exercise. RESULTS: Levels of IL-10 and TNF-α in response to exercise were similar in healthy and MS remitting subjects. Compared to baseline, TNF-α levels in relapsing subjects were significantly decreased immediately after exercise. Immediately following exercise, leptin levels significantly decreased in relapsing subjects. Adiponectin and IL-6 showed no significant difference between groups. CONCLUSION: After relapse, exercise does not induce inflammatory cytokine response and temporarily improves both cytokine and adipokine balance.