Lower-limb performance disparities: Implications for exercise prescription in multiple sclerosis

Larson, Rebecca D.; McCully, Kevin K.; Larson, Daniel J.; Pryor, William M.; White, Lesley J.

doi:10.1682/jrrd.2013.09.0191

Cited by 18 publications

(34 citation statements)

References 13 publications

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“…An early symptom of MS is weakness on one side of the body, particularly in the lower limbs ( White and Dressendorfer, 2005 ; Larson et al, 2014 ). Due to this unilateral weakness, people with MS (PwMS often have a more- and less-affected side of the body which results in a variety of asymmetries, including measures of power, strength, muscle activity, and limb loading ( Chung et al, 2008 ; Van Emmerik et al, 2010 ; Kalron et al, 2011 ; Sandroff et al, 2013 ; Rudroff et al, 2014 ; Ketelhut et al, 2015 ; Kalron, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of Muscle Function and Limb Loading Asymmetries on Gait and Balance in People With Multiple Sclerosis

Rudroff

Proessl

2018

Front. Physiol.

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People with MS (PwMS) often have a more- and less-affected side of the body which results in a variety of asymmetries, including measures of power, strength, muscle activity, and limb loading. Though many studies have identified asymmetries, their impact on gait and balance in PwMS is currently unclear. In this mini-review we first summarize previous findings of asymmetries in muscle function and limb loading and their impact on gait and balance in PwMS. We then provide potential explanations for this lack of consistency in the current literature, and propose study guidelines to improve future lower limb asymmetry studies. Making use of a unified approach to study lower limb asymmetry may then provide more clarity regarding their impact on mobility, specifically gait and balance, in PwMS.

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Section: Introductionmentioning

confidence: 99%

Effects of Muscle Function and Limb Loading Asymmetries on Gait and Balance in People With Multiple Sclerosis

Rudroff

Proessl

2018

Front. Physiol.

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“…39 Although we found robust improvements in oxidative capacity and endurance in the medial gastrocnemius muscle, it should also be considered that these findings may not reflect changes in other lower-extremity muscles. Moreover, previous studies have reported asymmetrical lower-limb muscle function in people with MS, 13,53 and the present study did not evaluate bilateral differences, which may have provided more insight when comparing exercisemediated adaptations in muscle endurance and walking function.…”

Section: Practice Pointsmentioning

confidence: 72%

Effects of Treadmill Training on Muscle Oxidative Capacity and Endurance in People with Multiple Sclerosis with Significant Walking Limitations

Willingham¹,

Melbourn²,

Moldavskiy³

et al. 2019

International Journal of MS Care

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Background: Exercise can improve muscle function and mobility in people with multiple sclerosis (MS). However, the effects of exercise training on skeletal muscle oxidative capacity and endurance in people with MS remain unclear, and few studies have evaluated muscle plasticity in people with MS who have moderate-to-severe disability. The present study evaluated the effects of treadmill training on muscle oxidative capacity and muscle endurance and examined the relationship to walking function in people with MS who have moderate-to-severe disability. Methods: Six adults (mean ± SD age, 50 ± 4.9 years) with MS (Expanded Disability Status Scale score, 6.0–6.5) performed treadmill training for 24 minutes approximately twice per week for approximately 8 weeks (16 sessions total) using an antigravity treadmill system. The following measures were taken before and after the intervention phase: muscle oxidative capacity in the medial gastrocnemius using near-infrared spectroscopy after 15 to 20 seconds of electrical stimulation; muscle endurance in the medial gastrocnemius using accelerometer-based mechanomyography during 9 minutes of twitch electrical stimulation in three stages (3 minutes per stage) of increasing frequency (2, 4, and 6 Hz); and walking function using the 2-Minute Walk Test. Results: Mean ± SD muscle oxidative capacity increased from 0.64 ± 0.19 min−1 to 1.08 ± 0.52 min−1 (68.2%). Mean ± SD muscle endurance increased from 80.9% ± 15.2% to 91.5% ± 4.8% at 2 Hz, from 56.3% ± 20.1% to 76.6% ± 15.8% at 4 Hz, and from 29.2% ± 13.1% to 53.9% ± 19.4% at 6 Hz of stimulation in the gastrocnemius. There were no significant improvements in walking function. Conclusions: Treadmill training can improve muscle oxidative capacity and endurance in people with MS who have moderate-to-severe levels of disability.

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“…This asymmetry varies from 2 to 30% for maximal muscle strength [56] and results in a greater muscle volume on the more affected side of the transversus abdominis, quadratus lumborum, and the low-back extensor muscle group, suggesting a compensatory mechanism to maintain balance and posture [52;58]. Furthermore, pwMS are able to perform significantly more work with the stronger leg than the weaker leg, during submaximal single-leg fixed-load cycling and compared to healthy controls [59]. Interestingly, endurance isokinetic knee extensor strength and isometric knee flexor strength are reported to be main predictors forrelate best to walking capacity [60].…”

Section: Muscle Function In Msmentioning

confidence: 99%

Muscular, cardiac, ventilatory and metabolic dysfunction in patients with multiple sclerosis: Implications for screening, clinical care and endurance and resistance exercise therapy, a scoping review

Wens

Eijnde

Hansen

2016

Journal of the Neurological Sciences

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In the treatment of multiple sclerosis (MS), exercise training is now considered a cornerstone. However, most clinicians tend to focus on neurologic deficits only, and thus prefer to prescribe rehabilitation programs specifically to counteract these deficits. However, the present comprehensive review shows that patients with MS (pwMS) also experience significant muscular, cardiac, ventilatory and metabolic dysfunction, which significantly contribute, next to neurologic deficits, to exercise intolerance. In addition, these anomalies also might increase the risk for frequent hospitalization and morbidity and can reduce life expectancy. Unfortunately, the impact of exercise intervention on these anomalies in pwMS are mostly unknown. Therefore, it is suggested that pwMS should be screened systematically for muscular, cardiac, ventilatory and metabolic function during exercise testing. The detection of such anomalies should lead to adaptations and optimisation of exercise training prescription and clinical care/medical treatment of pwMS. In addition, future studies should focus on the impact of exercise intervention on muscular, cardiac, ventilatory and metabolic (dys)function in pwMS, to contribute to improved treatment and care.

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Lower-limb performance disparities: Implications for exercise prescription in multiple sclerosis

Cited by 18 publications

References 13 publications

Effects of Muscle Function and Limb Loading Asymmetries on Gait and Balance in People With Multiple Sclerosis

Effects of Muscle Function and Limb Loading Asymmetries on Gait and Balance in People With Multiple Sclerosis

Effects of Treadmill Training on Muscle Oxidative Capacity and Endurance in People with Multiple Sclerosis with Significant Walking Limitations

Muscular, cardiac, ventilatory and metabolic dysfunction in patients with multiple sclerosis: Implications for screening, clinical care and endurance and resistance exercise therapy, a scoping review

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