Proceedings of The Physiological Society

AstraZeneca (2010) Proc Physiol Soc 18, PC30

Poster Communications

The effect of a 10 week exercise intervention on gastric emptying, appetite, food intake and cardiac autonomic function in multiple sclerosis

K. Horner1, M. Garrett2, S. Coote2, A. Shafat1

1. Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland. 2. Department of Physiotherapy, University of Limerick, Limerick, Ireland.


Multiple sclerosis is a progressive autoimmune disease in which autonomic nervous system dysfunction, delayed gastric emptying (GE) and sedentary lifestyles have been reported. Regular exercise is associated with accelerated GE in healthy adults. We investigated the effect of an exercise intervention on GE, heart rate variability (HRV; as an indicator of autonomic balance), appetite sensations and food intake in MS patients. Twelve MS patients (BMI 27.5±4.5 kg m-2; age 51.3±9.5 years) attended the laboratory at baseline and post test, after giving written informed consent. Six subjects self-selected to participate in a ten week exercise intervention (1 supervised strengthening exercise class in addition to independent aerobic exercise increasing from 2 to 3 sessions per week at week 5; exercise group (EXE); n = 6). Six others self-selected to participate in the control group ((CTL); n = 6) and were instructed to maintain their habitual lifestyle over the same time period (control group (CTL); n = 6). GE was assessed by 13C octanoic acid breath test, HRV in the frequency domain from resting electrocardiogram, subjective appetite sensations by visual analogue scales and food intake by food diary. Statistical analysis was conducted using Pearson correlations and mixed ANOVA (group x time). A large inter and intra individual variability was evident in all parameters. There were no significant correlations between any variables. The exercise intervention did not significantly change GE or HRV. Mean daily energy intake increased in the EXE group by 10.4±6.4% compared to a 26.9±24.6% decrease in the CTL group over time (p = 0.007). Area under the curve for 4hr postprandial hunger sensations was significantly reduced in the EXE group following intervention compared to the CTL group (p=0.047). Findings suggest that GE rate is not significantly associated with cardiac autonomic function in MS. The exercise intervention did not change autonomic function as reflected by GE and HRV parameters but increased daily energy intake and paradoxically decreased postprandial hunger sensations. Further randomised studies with larger sample sizes are desirable.

Where applicable, experiments conform with Society ethical requirements