Journal of Exercise & Organ Cross Talk
Journal of Eexercise & Organ Cross Talk

The effect of combined training (core stability, resistance and balance) on serum BDNF and GDNF levels in individuals with multiple sclerosis

Document Type : Original Article

Authors

Ahmad Shahid Razi 1
Khosro Jalali Dehkordi 2
Asaad Adnan Aziz 3
Farzaneh Taghian 4
Ahmad Chitsaz 5

1 PhD student, Department of Sports Physiology, Isf.C., Islamic Azad University, Isfahan, Iran

2 Associate Professor, Department of Sports Physiology, Faculty of Sports Sciences, Isf.C., Islamic Azad University, Isfahan, Iran

3 College of Physical Education and Sports Science, University of Al-Qadisiyah, Iraq

4 Professor, Department of Sports Physiology, Faculty of Sports Sciences, Isf.C., Islamic Azad University, Isfahan, Iran

5 Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

https://doi.org/10.22122/jeoct.2026.574002.1190
Abstract
Multiple sclerosis (MS) is a chronic neurological disease associated with neurodegeneration and impaired neurotrophic support. Neuromuscular training, through integrated activation of the nervous and muscular systems, may positively influence these neurotrophic factors. Therefore, this study investigated the effect of combined training on serum BDNF and GDNF levels in individuals with multiple sclerosis. Thirty women with multiple sclerosis (mean age: 36.2±5.8 years; BMI: 22.1±4.2 kg/m²) were purposively selected and randomly assigned to an experimental group (n=15) or a control group (n=15). The experimental group completed an eight-week combined training program (three sessions per week), consisting of core stability, resistance, balance, and agility exercises with progressive overload, while exercise intensity was controlled using the Borg perceived exertion scale., while the control group continued their usual daily activities. Blood samples were collected 24 hours before and 48 hours after the final training session, and the obtained serum was used to measure BDNF and GDNF levels. Data were analyzed using repeated-measures analysis of variance with a significance level of 0.05, employing SPSS software (version 27). The results demonstrated that neuromuscular training induced significant increases in serum BDNF (p=0.001, η²=0.80) and GDNF (p=0.001, η²=0.79) levels in the experimental group compared with the control group. Overall, the results of this study demonstrate that eight weeks of neuromuscular training elicit significant increases in serum BDNF and GDNF levels in women with multiple sclerosis. These findings indicate an enhanced neurotrophic environment that may support neural plasticity and neuroprotective mechanisms. Accordingly, neuromuscular training appears to be a safe and effective non-pharmacological strategy for improving neural health and potentially attenuating neurological dysfunctions associated with multiple sclerosis.

What is already known on this subject?

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by demyelination and impaired neural signal transmission. This condition can lead to a wide range of symptoms, including muscle weakness, motor dysfunction, impaired balance, chronic fatigue, and cognitive deficits, ultimately affecting patients’ quality of life. Immune, genetic, and environmental factors play important roles in the onset and progression of MS, and evidence suggests that chronic inflammation and alterations in neurotrophic factors are key mechanisms involved in its pathophysiology.

 

What this study adds?

Combined training training, by simultaneously engaging the nervous and muscular systems, can play an effective role in modulating neurotrophic factors. Evidence suggests that this type of training, through increased targeted motor activity, improved neuromuscular coordination, and reduced neural stress, leads to enhanced expression and secretion of key neurotrophic factors such as BDNF and GDNF. Elevated levels of these factors may contribute to improved neuronal survival and plasticity, facilitation of neural repair, and strengthening of synaptic connections, ultimately resulting in improved neural and motor function, particularly in individuals with neurological disorders such as multiple sclerosis.

Keywords

Combined training
BDNF
GDNF
Multiple sclerosis
Subjects

Acknowledgements

This article is derived from the master’s thesis conducted at the Islamic Azad University, Isfahan Branch. The authors would like to sincerely thank the Research Affairs of Islamic Azad University, Isfahan Branch, as well as all participants who kindly cooperated in the implementation of this study.

Funding

None.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Compliance with ethical standards

Conflict of interest the authors declare that there is no conflict of interest in the present research.

Ethical approval Given that the present study was conducted on human samples with exercise intervention over a relatively long period of time, in full compliance with the ethical principles of research, approval was received from the ethics committee with the ID number IR.IAU.KHUISF.REC.1404.525 from the Islamic Azad University, Isfahan (Khorasgan) Branch.

Informed consent Participants signed an informed consent form prior to participation in the study.

Author contributions 

Conceptualization: A.S.H., K.J,; Methodology: A.S.H., K.J.,F.T; Software: A.S.H., K.J; Validation: A.S.H., K.J.,F.T.AA.A; Formal analysis: K.J.; Investigation: A.S.H., K.J.,F.T.; Resources: A.S.H., K.J.,F.T.AA.A.; Data curation A.S.H., K.J.,F.T.; Writing - original draft: Z A.S.H., K.J.; Writing–review & editing: A.S.H., K.J.,F.T.; Visualization: A.S.H., K.J.,F.T.AA.A.; Supervision: K.J.; Project administration: A.S.H., K.J.; Funding acquisition: A.S.H.    

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Journal of Exercise & Organ Cross Talk
Volume 6, Issue 1
Winter 2026
Pages 25-32

  • Receive Date 04 December 2025
  • Revise Date 18 February 2026
  • Accept Date 21 February 2026

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