{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:40:30Z","timestamp":1772692830151,"version":"3.50.1"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Rehabil. Sci."],"abstract":"\n Background<\/jats:title>\n \n Accurate exercise prescription in persons with multiple sclerosis (MS) depends on cardiopulmonary exercise testing (CPET). Obtaining an accurate VO\n 2max<\/jats:sub>\n can be challenging when patients experience lower limb impairment and fatigue that can change over time.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n We sought the optimal adapted device to achieve a maximal CPET among persons with MS.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In a randomized crossover trial with within-subject, repeated measures design, clinic-referred persons with MS (\n n<\/jats:italic>\n \u2009=\u200910) with three-month stability, no exercise obstruction, ability to walk with or without assistance, and sex- and age-matched (\u00b13 years) Controls (\n n<\/jats:italic>\n \u2009=\u20097) were recruited by convenience sampling. Participants performed CPET on body weight-supported treadmill (BWST) and total body recumbent stepper (TBRS). We collected standard aerobic metrics, including\n \n \n \n \n \n V<\/mml:mi>\n <\/mml:mrow>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n \n \n O<\/mml:mi>\n <\/mml:mrow>\n \n 2<\/mml:mn>\n max<\/mml:mo>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:math>\n <\/jats:inline-formula>\n , % normative values for\n \n \n \n \n \n V<\/mml:mi>\n <\/mml:mrow>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n \n \n O<\/mml:mi>\n <\/mml:mrow>\n \n 2<\/mml:mn>\n max<\/mml:mo>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:math>\n <\/jats:inline-formula>\n (%\n \n \n \n \n \n V<\/mml:mi>\n <\/mml:mrow>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n \n \n O<\/mml:mi>\n <\/mml:mrow>\n \n 2<\/mml:mn>\n max<\/mml:mo>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:math>\n <\/jats:inline-formula>\n ), heart rate maximum (HR\n max<\/jats:sub>\n ), age-predicted HR\n max<\/jats:sub>\n , and Respiratory Exchange Ratio.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n MS patients, regardless of disability severity, achieved similar\n \n \n \n \n \n V<\/mml:mi>\n <\/mml:mrow>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n \n \n O<\/mml:mi>\n <\/mml:mrow>\n \n 2<\/mml:mn>\n max<\/mml:mo>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:math>\n <\/jats:inline-formula>\n values (mL\u00b7min\n \u22121<\/jats:sup>\n \u00b7kg\n \u22121<\/jats:sup>\n ) on the TBRS and BWST. Control participants obtained higher values on BWST (40.27\u2009\u00b1\u20097.6 vs. 34.32\u2009\u00b1\u20097.1,\n p<\/jats:italic>\n \u2009&lt;\u20090.001). MS patients more consistently met the criteria for maximal CPET using the TBRS (\n n<\/jats:italic>\n \u2009=\u20099\/10 vs. 6\/10 on BWST).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n \n \n \n \n \n V<\/mml:mi>\n <\/mml:mrow>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n \n \n O<\/mml:mi>\n <\/mml:mrow>\n \n 2<\/mml:mn>\n max<\/mml:mo>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:math>\n <\/jats:inline-formula>\n was similar between devices among MS patients. On BWST, they achieved lower\n \n \n \n \n \n V<\/mml:mi>\n <\/mml:mrow>\n \u02d9<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n \n \n O<\/mml:mi>\n <\/mml:mrow>\n \n 2<\/mml:mn>\n max<\/mml:mo>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:math>\n <\/jats:inline-formula>\n values compared to Controls. MS patients more successfully achieved the primary criterion, VO\n 2<\/jats:sub>\n plateau (\u2264150\u2005ml\/min\n \u22121<\/jats:sup>\n ), using TBRS. Additionally, TBRS permitted persons with mobility disability to achieve more criteria for a maximum CPET. Our results suggest that CPET using BWST, being reliant on the lower body, likely disadvantages MS patients, especially those with mobility disability.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fresc.2026.1731215","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T05:25:32Z","timestamp":1772688332000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Body-weight supported treadmill or total body recumbent stepper for mobility-adapted cardiopulmonary exercise testing in multiple sclerosis patients with varying disability"],"prefix":"10.3389","volume":"7","author":[{"given":"Saman","family":"Hadjizadeh Anvar","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Memorial University of Newfoundland","place":["St. John\u2019s, NL, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liam 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