Exercise, Exercise, Exercise


It’s possible if repeated enough times it may actually turn out to be true and not end up being a one ‘big lie’. Keeping on the COVID theme, how many of you have heard of COVID-15?

COVID-15: The 15 lbs of weight gain caused by nervously binge eating your COVID-19 food stockpile.

Jokes aside, evidence points to exercise being beneficial for not only boosting your metabolism (and ergo your weight), but also maintaining positive neural feedback thereby encouraging neural plasticity.

Neural plasticity can be defined as the ability of the central nervous system (CNS) to adapt in response to changes in the environment or lesions.

In a recently published work, investigators looked at trophic factors that have been associated with brain plasticity before and after excercise. They found (ignoring the fact that the study only had female participants) an increase in all neurotrophin levels, except for GDNF and CNTF (see Figure below). There was no significant influence of disability levels on this suggesting that exercise is still beneficial in the higher ends of disability.

Figure: Neurotrophic factors change following 12 weeks of combined exercise training.
* Indicate significant effect based on p<0.05. BDNF: Brain-derived neurotrophic factor; GDNF: Glial cell-derived neurotrophic factor; CNTF: Ciliary neurotrophic factor; NT: Neurotrophin.

This is not the first study of its kind and positive effects of excercise have been demonstrated on BDNF and NT in the past. If you’re interested in learning more about this, here is a good review on the effects of exercise on BDNF and memory: https://www.frontiersin.org/articles/10.3389/fnins.2018.00052/full.


Mult Scler Relat Disord. 2020 May 13;43:102143. doi: 10.1016/j.msard.2020.102143. Online ahead of print.

Exercise Improves Neurotrophins in Multiple Sclerosis Independent of Disability Status

Ebrahim BanitalebiMajid Mardaniyan GhahfarrokhiRaoof Negaresh Abdolreza KazemiMohammad FaramarziRobert W MotlPhilipp Zimmer

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.

About the author

Neuro Doc Gnanapavan


    • Ketone Bodies as a Fuel for the Brain during Starvation

      “Obese nurse who had recurring chest pain to him forevaluation and for possible prolonged fasting for weight
      loss. The patient, Ms. B., was motivated by fear of having
      a heart attack; her father had died from a myocardial
      infarction, and her mother had suffered several heart attacks.
      Physical examination revealed a large-framed
      woman whose height was 5 feet 8 inches, with a body
      weight of 280 pounds and blood pressure of 140/90. Her
      total plasma cholesterol was 360 mg/dl, and her fasting
      blood glucose was 112 mg/dl. Other routine laboratory
      tests were normal. Her resting electrocardiograms did not
      suggest that she had inadequate cardiac circulation, but
      from her medical history we suspected that she had insufficient
      blood flow through her heart. The most definitive
      test for determining cardiac blood flow was coronary angiography
      with left ventriculography. These tests required
      placing catheters into a peripheral artery in the thigh or
      forearm and threading the catheter into the coronary arteries
      and into the major chambers of the heart and filling
      these sites with contrast dye that could be seen on x-rays.
      None of us realized at the time Ms. B. was hospitalized
      on the Peter Bent Brigham Clinical Research Center that
      she was a godsend for our research.6 She understood the
      research starvation protocol and the catheterization studies
      that were planned in addition to her diagnostic heart
      studies, and she admired and trusted Dr. Cahill and hisstaff. Ms. B. knew how 24-h urinary collections were performed
      and was compulsive in voiding urine and collecting
      her specimens accurately. Later, other volunteer-patients
      followed the pattern she and our research team developed.
      The length of time selected for our starvation study
      of Ms. B. was 6 weeks. When someone asked me why we
      chose the 6-week period, I replied that “Jesus fasted forty
      days and forty nights; and afterward he hungered” (St.
      Matthew 4:2We began our study by putting Ms. B. on a balanced diet
      of proteins, fat, and carbohydrates, and after a few days
      on the diet, we initiated an approved starvation protocol.
      She received water, salt tablets, and vitamins. Our research
      team made daily recordings of her weight, blood
      pressure, body temperature, and pulse and also measured
      her total body energy requirements using indirect calorimetry.
      Urine was collected daily to determine the rate of
      excretion of nitrogenous waste compounds, and blood
      was sampled periodically for the routine analysis of metabolites.
      After Ms. B. had fasted for 41 days, we inserted
      multiple catheters into her blood vessels to measure
      the exchange rate of metabolic materials between the
      brain and liver. Although our team at the cardiac catheterization
      laboratory had provided for every safety precaution,
      we were concerned about the inherent risks of ob-taining multiple artery and venous blood samples from a
      patient who had not eaten for 41 days. Simultaneous
      arterial and venous blood samples were obtained over a
      10-s timed period from around Ms. B.’s brain and liver, and
      the level of metabolites was determined. We were thrilled
      to learn Ms. B.’s brain had survived this long period of
      starvation by metabolizing ketone bodies and greatly diminishing
      the use of glucose.

    • Resistance exercise: biceps curl, triceps extension, bench press, seated row, heel raises, leg extension, squat. Done as 3 sets.
      Endurance exercise: cycling or running for 20min (mod disability), body weight supported treadmill training or cycling for 20min (high disability)
      Balance exercise: static postural control; weight shifting 15min
      Pilates: 15min
      Stretching: 10min
      All done x3/week

      • Rowing is an excellent exercise. Full body weight bearing and cardio. Plus it is easy on the joints and doesn’t require much balance. If one side is more weak, the other side can help to compensate. I find that it is the best thing I’ve been able to do during an exacerbation. I use a Concept 2 Rower.



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