Effects of long-term resistance training and simultaneous electro-stimulation on muscle strength and functional mobility in multiple sclerosis

Broekmans, Tom; Roelants, Machteld; Feys, Peter; Alders, Geert; Gijbels, Domien; Hanssen, Ine; Stinissen, Piet; Eijnde, Bert O.

doi:10.1177/1352458510391339

Cited by 107 publications

(108 citation statements)

References 59 publications

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“…1 Due to the variety of functional disability in patients with MS, rehabilitation intervention, especially exercise therapy, is a necessary part of their treatment protocol. 2 In general, different types of exercise therapy are used to enhance functional activity, muscle strength, and mobility in patients with MS. [3][4][5] The results of these studies showed not only that aerobic exercises can cause physiologic changes 5 and improve ambulatory function and fatigue 6 but also that strength training exercise can increase muscle fiber size 7 and muscle strength 3 and improve functional activities and balance in patients with MS. 4 In a systematic review study, the authors suggested that "resistance training of moderate intensity seems to be well tolerated and to have beneficial effects on patients with MS." 8(p51) Endurance and resistance training sessions have been designed based on concentric contraction (contraction accompanied by shortening of muscle length, eg, uphill walking) of the involved muscles, which causes muscular hypertrophy and improves functional activity. 9 It must be pointed out that these types of exercises are generally considered high-intensity training (60%-80% of the maximum voluntary contraction force), which may tire out patients with MS. 10 However, some research has shown that eccentric exercise training (contraction accompanied by elongation of muscle length, eg, downhill walking), compared with concentric exercise, may improve balance in elderly people 11 and increase muscle strength in patients with Parkinson disease 12 and MS. 13 This is due to its potential for high muscle force production at a uniquely low energy cost 14 so that downhill walking (as a model of eccentric exercise) requires less energy cost than uphill walking (as a model of concentric exercise).…”

mentioning

confidence: 99%

Uphill and Downhill Walking in Multiple Sclerosis

Samaei

Bakhtiary

Hajihasani

et al. 2016

International Journal of MS Care

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mentioning

confidence: 99%

Uphill and Downhill Walking in Multiple Sclerosis

Samaei

Bakhtiary

Hajihasani

et al. 2016

International Journal of MS Care

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“…Only three studies in the systematic review of PRT 1 measured balance; two studies found an increase in functional reach, 5,6 and one did not find an effect on balance measured by a force platform. 7 The effect of PRT on balance therefore remains unclear, and the specificity of training principle may once again come into play.…”

Section: Proposalmentioning

confidence: 99%

Progressive resistance therapy is not the best way to rehabilitate deficits due to multiple sclerosis: Yes

Coote

2014

Mult Scler

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MULTIPLE SCLEROSIS MSJ JOURNAL ProposalProgressive resistance training (PRT) is a promising intervention that may be appropriate to increase strength for some patients; however, there is insufficient evidence for its benefit for rehabilitating other deficits due to multiple sclerosis (MS). A recent systematic review found 16 papers that studied the effect of PRT. 1 Of concern is the finding that only one of the studies met the criteria for blinding of assessors. The lack of blind assessors is a source of detection bias and suggests that the results of 15 papers in that review must be interpreted with an element of caution.When considering the symptoms of MS, gait is reported as the main problem, 2 but the evidence from the two largest resistance trials is conflicting. Dalgas et al. 3 reported that resistance training had a significant effect on walking tests, while Dodd et al. 4 found no significant improvements in walking. The complex motor task that is walking and the specificity principle of motor learning means the lack of effect on walking tests is not an unsurprising result. If you want to get better at a tennis serve you don't practise a golf swing -therefore in order to see an improvement in walking endurance or walking speed, interventions that involve a small number of repetitions performed in sitting or lying positions are, most likely, not going to improve those parameters.Fatigue is also a major issue for people with MS; however, only three studies in the systematic review 1 measured the effect of PRT on fatigue, 3-5 albeit finding positive results. Only one had a blinded assessor, and the total number of patients in the intervention groups was 70, which arguably is too few to enable a robust statement about the benefits of PRT on fatigue to be made.Balance is an issue affecting a significant proportion of people with MS; however, the effect of PRT on balance is not clear. Only three studies in the systematic review of PRT 1 measured balance; two studies found an increase in functional reach, 5,6 and one did not find an effect on balance measured by a force platform. 7 The effect of PRT on balance therefore remains unclear, and the specificity of training principle may once again come into play.Despite advances in the drug management of MS, many people still progress to a level of disability that requires use of a walking aid. It is difficult to establish how PRT affects walking aid users as their results have been combined with people with fewer mobility limitations in studies to date. Given the severity of symptoms and the complex combinations of symptoms that result in the need for a walking aid, it is possible that these individuals will not respond similarly to those with lower Expanded Disability Status Scale scores; studies specifically addressing this group are needed.The "best" intervention is one that, through a clinical reasoning process, addresses the symptoms of the person, and assists in meeting their specific goals. One size therefore does not fit all, given that the symptoms of MS a...

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“…A randomised controlled trial involving 36 patients highlighted that long-term intense resistance training improved muscle strength (maximal isometric strength of both knee extensor and flexor muscles), but did not change dynamic muscle strength and functional mobility [31].…”

Section: Jmir Serious Games [33]mentioning

confidence: 99%

Neurorehabilitation in Persons with Multiple Sclerosis: Scientific Basis and Options of Treatment

Pappalardo¹,

Amico²,

Chisari³

2016

J Mult Scler

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Effects of long-term resistance training and simultaneous electro-stimulation on muscle strength and functional mobility in multiple sclerosis

Abstract: Background. Resistance training studies in MS often use short intervention periods.

Cited by 107 publications

References 59 publications

Uphill and Downhill Walking in Multiple Sclerosis

Uphill and Downhill Walking in Multiple Sclerosis

Progressive resistance therapy is not the best way to rehabilitate deficits due to multiple sclerosis: Yes

Neurorehabilitation in Persons with Multiple Sclerosis: Scientific Basis and Options of Treatment

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