Effects of Maximal Strength Training on Perceived-Fatigue and Functional Mobility in Persons with Relapsing-Remitting Multiple Sclerosis

Abstract

Background and objectives: Fatigue is one of the most disabling symptoms that limit daily life activities in persons with multiple sclerosis (pwMS). This study aimed to evaluate the effects of maximal strength training (MST) on perceived-fatigue and functional mobility in pwMS. Materials and Methods: 26 participants with MS were balanced according to their pre-intervention fatigue scores and distributed into an MST group (n = 13) and a control group (CG; n = 13). The MST group completed eight weeks using high loads, evaluating detraining after ten weeks. Quadriceps and hamstring isokinetic (QPTIK; HPTIK) and isometric (QPTIM; HPTIM) peak torques were assessed using an isokinetic dynamometer. Effect size differences were estimated with the Hedges’ g index (dg). Fatigue was evaluated through the Fatigue Severity Scale (FSS), while functional mobility was assessed via the Timed Up and Go Test (TUG). Results: The MST significantly improved all the strength measurements after the intervention (Δ6.43–29.55%; p < 0.05) compared to the control group. FSS showed a significant reduction (59.97%, dg = 5.41, large). The MST group also reduced the TUG time (19.69%; dg = 0.93, large) compared to the control group. Improvements caused by the intervention did not remain after a 10-week follow-up, with decreases in strength performance from 4.40% to 13.86% (dg = 0.24–0.56, small to moderate), 112.08% in the FSS (dg = −3.88, large), and 16.93% in TUG (dg = −1.07, large). Conclusions: MST (up to 90% 1RM) seems to be a feasible and useful way to obtain clinically relevant improvements in the perceived-fatigue symptoms and functional mobility. Still, symptom improvements decrease after a 10-week detraining period.

Effectiveness of physical activity interventions on reducing perceived fatigue among adults with chronic conditions: a systematic review and meta-analysis of randomised controlled trials

“…While only three trials presented as low risk 77 , 83 , 98 . In the domain of missing outcome data, 22 trials presented a low risk of bias 37 , 61 , 68 , 70 , 72 , 74 , 76 , 79 – 81 , 83 – 86 , 90 , 91 , 93 , 95 – 99 while only four presented a high risk of bias 62 , 64 , 78 , 88 . 15 trials showed a low risk of bias 61 , 70 – 72 , 78 , 79 , 83 , 86 , 87 , 90 , 91 , 93 , 95 – 97 in the measurement of outcome domain while three showed a high risk of bias 73 , 74 , 88 .…”

“…In the domain of missing outcome data, 22 trials presented a low risk of bias 37 , 61 , 68 , 70 , 72 , 74 , 76 , 79 – 81 , 83 – 86 , 90 , 91 , 93 , 95 – 99 while only four presented a high risk of bias 62 , 64 , 78 , 88 . 15 trials showed a low risk of bias 61 , 70 – 72 , 78 , 79 , 83 , 86 , 87 , 90 , 91 , 93 , 95 – 97 in the measurement of outcome domain while three showed a high risk of bias 73 , 74 , 88 . Ten trials presented a low risk of bias 61 , 72 , 86 , 87 , 91 , 93 , 95 – 97 , 117 in the selection of reported results while no trials presented a high risk.…”

Is Resistance Training an Option to Improve Functionality and Muscle Strength in Middle-Aged People with Multiple Sclerosis? A Systematic Review and Meta-Analysis

“…Regarding fatigue and its influence on the frailty of the population under consideration, previous studies have demonstrated the efficacy of resistance exercise as a mitigating factor for this effect [ 60 ]. Additionally, noteworthy is the impact that the combination of resistance training with motor control training can have on fatigue, leading to significant improvements in fatigue levels [ 61 ].…”

Effect of strength training on functional outcomes and strength in patients with polyneuropathy: A scoping review

“…Irrespective of cause, PNP often results in considerable functional impairments, i.e., increased tendency to fall, dependency on walking aids, inability to ascend-descend stairs and difficulties in activities of daily living ( Callaghan et al, 2015 ; Hoffman et al, 2015 ). Strength training has been shown to improve strength, gait and functional outcomes in healthy young and older adults ( de Vos et al, 2005 ; Liu and Latham, 2009 ; Garber et al, 2011 ; Raymond et al, 2013 ; Borde et al, 2015 ; Hvid et al, 2016 ; Chen et al, 2021 ), patients with stroke ( Hill et al, 2012 ) and patients with multiple sclerosis ( Dalgas et al, 2009 ; Gomez-Illan et al, 2020 ). Since treatment only exists for very few percentages of the potential underlying causes (inflammatory) it is obvious to consider if strength training could be a potential treatment to counteract functional impairments and loss of physical capacity in patients with PNP.…”