Moderate resistance exercise program: Its effect in slowly progressive neuromuscular disease

Aitkens, Susan G.; McCrory, Megan A.; Kilmer, David D.; Bernauer, E. M.

doi:10.1016/0003-9993(93)90031-5

Cited by 133 publications

(67 citation statements)

References 8 publications

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“…In fact, the potential benefits and risks of exercise in neuromuscular diseases have been debated for years. 1,4,6,7,11,13 Recently, Aitkens and colleagues showed that moderate-resistance exercise over a 12-week period in 27 patients with various neuromuscular disorders was practical and safe and produced moderate improvement in both isokinetic and isometric muscle strength. 1 In further studies, the same group found that high-resistance training over a similar time period showed no benefit over moderate-resistance exercise and, in fact, was associated with loss of strength in some muscle groups.…”

Section: Discussionmentioning

confidence: 97%

Further observations on forearm flexor weakness in inclusion body myositis

1998

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Section: Discussionmentioning

confidence: 97%

Further observations on forearm flexor weakness in inclusion body myositis

1998

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“…Current consensus is that submaximal effort strengthening regimens, designed to avoid disuse atrophy while preventing exercise-induced muscle injury and disease progression, are probably safe and appropriate. 301,302 Wright et al 296 examined the effects of a 12-week walking program in adults with slowly progressive NMD and found that walking 15 to 30 minutes 3 to 4 days a week at 50% to 60% of heart rate reserve produced very modest but statistically significant decreases in submaximal heart rate and systolic blood pressure. Whether such exercise is capable of producing meaningful benefits to significantly impact the trajectory of cardiac involvement in patients with NMDs is not known.…”

Section: Other Therapies and Considerations For Nmd-associated Cardiamentioning

confidence: 99%

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Feingold¹,

Mahle²,

Auerbach³

et al. 2017

Circulation

211

195

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For many neuromuscular diseases (NMDs), cardiac disease represents a major cause of morbidity and mortality. The management of cardiac disease in NMDs is made challenging by the broad clinical heterogeneity that exists among many NMDs and by limited knowledge about disease-specific cardiovascular pathogenesis and course-modifying interventions. The overlay of compromise in peripheral muscle function and other organ systems, such as the lungs, also makes the simple application of endorsed adult or pediatric heart failure guidelines to the NMD population problematic. In this statement, we provide background on several NMDs in which there is cardiac involvement, highlighting unique features of NMD-associated myocardial disease that require clinicians to tailor their approach to prevention and treatment of heart failure. Undoubtedly, further investigations are required to best inform future guidelines on NMD-specific cardiovascular health risks, treatments, and outcomes. N euromuscular diseases (NMDs) encompass a broad spectrum of diagnoses with overlapping but distinct phenotypes. Common to many NMDs is cardiac involvement. Although the past 3 decades have seen marked advances in our understanding of many NMDs, significant gaps in knowledge remain on how best to approach cardiac care in these patients. For example, survival in Duchenne muscular dystrophy (DMD) has been extended through the use of glucocorticoid use and respiratory support, yet cardiac complications remain a significant cause of morbidity and mortality.1-3 To achieve further gains in care, we will need to improve our understanding of the pathophysiologies driving cardiac involvement in NMDs and advance treatments aimed at preventing the progression of heart failure (HF) and sudden death in NMDs. The recently published findings of an expert working group on cardiac involvement in DMD, which outlined key gaps in knowledge and made specific recommendations aimed at improving diagnosis and management, are a step toward this goal. 4 In this statement, we include a comprehensive overview of the major categories of NMDs with cardiac involvement. For each, a brief background of the gene defect(s), common clinical manifestations (particularly cardiac findings), and current therapies is summarized. Gaps in knowledge are highlighted, and where possible, clinical treatment suggestions are made by the expert writing group appointed by the American Heart Association to review the available literature. Selection of the writing group was performed in accordance with the American Heart Association's conflict-of-interest management policy. Participants volunteered to write sections relevant to their expertise and experience. CLINICAL STATEMENTS AND GUIDELINESconducted a general search of the literature, restricted to human subjects research published between 1980 and 2016. Drafts of each section were written and sent to the chair of the writing group for incorporation into a single document, which was then edited. The edited document was discussed electron...

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“…The choice of this modality of PNF treatment was based on the evidence that low-and moderate-intensity training increases muscle strength in patients with CMT-1A 16 , and that high-intensity protocols can cause muscle injuries in these patients 17 . By using the strongest muscles furthest to the target of the force irradiation, muscle injury was prevented in the participants in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Aitkens et al 16 and Kilmer et al 17 demonstrated that lowand moderate-intensity strengthening protocols (with weights on the fist and ankle, 12 weeks of treatment with three weeks in submaximal regime) in patients with neuromuscular diseases, including CMT-1A, improve upper and lower limb muscle strength 16 . In contrast, an intensive strengthening protocol with progressive training frequency, volume and, especially, intensity (12 weeks, one set of ten repetitions progressing to five sets, and three times progressing to four times a week) increases the risk of training-induced injury in patients with neuromuscular disease 17 .…”

Section: Introductionmentioning

confidence: 99%

Irradiação contralateral de força para a ativação do músculo tibial anterior em portadores da doença de Charcot-Marie-Tooth: efeitos de um programa de intervenção por FNP

Meningroni

Nakada

Hata

et al. 2009

Rev. bras. fisioter.

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Objective: To evaluate the response of the tibialis anterior (TA) muscle following a five-week protocol with contralateral irradiation force through Proprioceptive Neuromuscular Facilitation (PNF) diagonals in patients with demyelinating polyneuropathy associated with Charcot-MarieTooth disease type 1A (CMT-1A). Methods: The study included 12 patients of both sexes. They were treated twice-weekly for 5 weeks. At each session, they performed the following diagonal patterns: chopping, extension-adduction with internal rotation (EAIR) and flexion-abduction with internal rotation (FAIR). The diagonals were repeated four times, in both upper and lower limbs, with each repetition lasting six seconds on average. During execution, the response of the TA muscle was recorded by a surface electromyograph disregarding the initial and final two seconds of each diagonal. The mean RMS values of the four repetitions were normalized in percentage. The initial and final data were analyzed through the t test for paired samples with significant p-values <0.05. Results: The contralateral force irradiation with the chopping diagonal to the left and to the right increased the percentage RMS values of the TA muscle in the last session when compared with the values of the first session (t=-3.94 and t=-3.87, respectively). Similarly, the EAIR diagonal increased the percentage RMS values of the TA muscle in the last session when compared with the values of the first session (t=-3.3 and t=-4.58, respectively). The only diagonal that did not produce higher values of contralateral force irradiation in the TA muscle, left and right, was the FAIR (t=-2.31 and t=-1.55). Conclusion: These results may justify the use of a treatment program with PNF diagonals in patients with CMT-1A who have difficulty activating the TA muscle.Key words: Charcot-Marie-Tooth Disease; proprioceptive neuromuscular facilitation technique; peripheral demyelination; electromyographic evaluation. ResumoObjetivo: Avaliar a resposta do músculo tibial anterior (TA) após um protocolo de cinco semanas com irradiação contralateral de força através de diagonais de facilitação neuromuscular proprioceptiva (FNP) em pacientes com polineuropatia desmielinizante associada à doença de Charcot-Marie-Tooth do tipo 1A (CMT-1A). Métodos: Participaram deste estudo 12 pacientes, de ambos os sexos. Eles foram tratados em uma frequência de duas vezes por semana, durante cinco semanas. Em cada sessão, foram utilizadas as diagonais de Chopping, extensão-adução com rotação interna (EARI) e flexão-abdução com rotação interna (FARI). As diagonais foram repetidas quatro vezes, em ambos os membros superiores e inferiores; cada diagonal tinha duração média de 6 segundos. Durante as execuções, a resposta muscular do TA foi registrada por um eletromiógrafo de superfície, desprezando-se os 2 segundos iniciais e finais de cada diagonal. A média dos valores de Root Mean Square (RMS) das quatro repetições foi normalizada em porcentagem. Os dados iniciais e finais foram submetidos ao teste em t par...

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Moderate resistance exercise program: Its effect in slowly progressive neuromuscular disease

Cited by 133 publications

References 8 publications

Further observations on forearm flexor weakness in inclusion body myositis

Further observations on forearm flexor weakness in inclusion body myositis

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Irradiação contralateral de força para a ativação do músculo tibial anterior em portadores da doença de Charcot-Marie-Tooth: efeitos de um programa de intervenção por FNP

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