Pilot Randomized Trial of Progressive Resistance Exercise Augmented by Neuromuscular Electrical Stimulation for People With Multiple Sclerosis Who Use Walking Aids

Coote, Susan; Hughes, Lonan; Rainsford, Gary; Minogue, Conor; Donnelly, Alan

doi:10.1016/j.apmr.2014.09.021

Cited by 34 publications

(37 citation statements)

References 40 publications

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“…willingness of participants to be randomised to the proposed treatment group(s)No examplesNot assessedResources: assesses the time and resource problems that can occur during the main studyEstimate retention of participants in the study [23, 24] a (e.g. number of participants completing all aspects of study, number and reason for attrition)All participants completed study [35, 37, 39, 41, 44, 47, 52]Drop out reasons: the intervention [7, 38, 58]; changes in time commitments [35, 51, 58]; unable to travel [42, 45, 46]; MS relapse [52]; other medical issues [7, 43, 45, 58]; non-compliance with the study protocol [7]; and lost contact [35, 37, 45]90% of all participants completed studyDrop out reasons: changes in time commitment and other medical issuesDemonstrate appropriate eligibility criteria [23, 24] a (e.g. are criteria too inclusive/exclusive)All participants met inclusion criteria [47, 55]Exclusion reasons: participants were too active [35, 41]; too old [35]; recent relapse [35]; participation in another trial [35]; participation in formal rehabilitation [42]; non-MS diagnosis [35]; recent change in disease modifying therapy [35]; high fall history [41]; and cognitive deficits [41]32% of interested parties did not meet inclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

“…Exclusion reasons; too active, low self-reported disability levelEstimate barriers/refusals to participation [23, 24] a (e.g. participant transportation problems)Barriers identified: unable to travel [45, 46]; a change in personal time commitments [35, 51, 58]; MS relapse [52]; and other medical issues [7, 43, 45, 58]10% of interested parties chose not to participate; unable to commit timeDemonstrate compliance with study protocol [23, 24] a (e.g. do participants adhere to correct dosage of intervention sessions)Recorded via attendance at intervention [35, 37–40, 42–47, 50, 52, 58]; participant self-completed activity diaries [35, 37, 45–47]75% of intervention participants were fully compliant with exercise sessionsDemonstrate participants reaction to data collection and outcome assessments [23, 24] a (e.g.…”

Section: Methodsmentioning

confidence: 99%

“…[7] vs. [8]), and this is associated with limitations of previous RCTs. For example, there is limited evidence for the duration of benefits from participation in the exercise intervention after cessation of the intervention period [9–11].…”

Section: Introductionmentioning

confidence: 99%

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Important considerations for feasibility studies in physical activity research involving persons with multiple sclerosis: a scoping systematic review and case study

Learmonth

Motl

2017

Pilot Feasibility Stud

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BackgroundMuch research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis (MS). There is disagreement regarding the strength of this research, perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing. We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS.MethodA systematic scoping review was conducted based on a literature search of five databases to identify feasibility processes described in preliminary studies of physical activity in MS. We read and extracted methodology from each study based on the following feasibility metrics: process (e.g. recruitment), resource (e.g. monetary costs), management (e.g. personnel time requirements) and scientific outcomes (e.g. clinical/participant reported outcome measures). We illustrate the use of the four feasibility metrics within a randomised controlled trial of a home-based exercise intervention in persons with MS.ResultsTwenty-five studies were identified. Resource feasibility (e.g. time and resources) and scientific outcomes feasibility (e.g. clinical outcomes) methodologies were applied and described in many studies; however, these metrics have not been systematically addressed. Metrics related to process feasibility (e.g. recruitment) and management feasibility (e.g. human and data management) are not well described within the literature. Our case study successfully enabled us to address the four feasibility metrics, and we provide new information on management feasibility (i.e. estimate data completeness and estimate data entry) and scientific outcomes feasibility (i.e. determining data collection materials appropriateness).ConclusionOur review highlights the existing research and provides a case study which assesses important metrics of study feasibility. This review serves as a clarion call for feasibility trials that will substantially strengthen the foundation of research on exercise in MS.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Important considerations for feasibility studies in physical activity research involving persons with multiple sclerosis: a scoping systematic review and case study

Learmonth

Motl

2017

Pilot Feasibility Stud

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“…31 Changes in the remaining five muscles tested had a higher MDC 95% (range, 33%-58%). Nevertheless, there have been reports of strength changes measured by HHD of up to 53% in hip extension and 95% in knee extension for people with MS. 19,20 Other studies have measured comparable improvements using isokinetic dynamometry for ankle plantarflexion (range, 52%-55%) 46,47 and maximal repetitions on leg press and reverse leg press (range, 29%-32%). 48,49 Although data from this study on response stability are promising, more investigation is needed on the responsiveness of these measures, including meaningful change.…”

Section: Resultsmentioning

confidence: 95%

“…Compared with MMT, HHD quantifies strength more accurately, 13 is more responsive to small changes in muscle strength, 14 and may be more reliable. 9,11 Although not as common in research as isokinetic dynamometry, HHD has been used in a variety of studies in people with MS. [15][16][17][18][19][20] Handheld dynamometry has adequate concurrent validity to isokinetic dynamometry in both healthy and other neurologic populations and has been proposed as a clinically feasible alternative to isokinetic dynamometry in terms of cost, ease of use, and efficiency. 12 Handheld dynamometry has the potential to be a useful clinical outcome for people with MS; however, little is known about its psychometric properties in this population.…”

Section: Participantsmentioning

confidence: 99%

Psychometric Properties of a Clinical Strength Assessment Protocol in People with Multiple Sclerosis

Mañago¹,

Hebert²,

Schenkman³

2017

International Journal of MS Care

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Background: Strength training in people with multiple sclerosis (MS) is an important component of rehabilitation, but it can be challenging for clinicians to quantify strength accurately and reliably. This study investigated the psychometric properties of a clinical strength assessment protocol using handheld dynamometry and other objective, quantifiable tests for the lower extremities and trunk in people with MS.

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Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease

Jones

Man

Gao

et al. 2016

Cochrane Database of Systematic Reviews

164

108

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Background This review is an update of a previously published review in the Cochrane Database of Systematic Reviews Issue 1, 2013 on Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease. Patients with advanced progressive disease often experience muscle weakness, which can impact adversely on their ability to be independent and their quality of life. In those patients who are unable or unwilling to undertake whole-body exercise, neuromuscular electrical stimulation (NMES) may be an alternative treatment to enhance lower limb muscle strength. Programmes of NMES appear to be acceptable to patients and have led to improvements in muscle function, exercise capacity, and quality of life. However, estimates regarding the effectiveness of NMES based on individual studies lack power and precision. Objectives Primary objective: to evaluate the effectiveness of NMES on quadriceps muscle strength in adults with advanced disease. Secondary objectives: to examine the safety and acceptability of NMES, and its effect on peripheral muscle function (strength or endurance), muscle mass, exercise capacity, breathlessness, and health-related quality of life. Search methods We identified studies from searches of the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (CDSR), and Database of Abstracts of Reviews of Effects (DARE) (the Cochrane Library), MEDLINE (OVID), Embase (OVID), CINAHL (EBSCO), and PsycINFO (OVID) databases to January 2016; citation searches, conference proceedings, and previous systematic reviews. Selection criteria We included randomised controlled trials in adults with advanced chronic respiratory disease, chronic heart failure, cancer, or HIV/ AIDS comparing a programme of NMES as a sole or adjunct intervention to no treatment, placebo NMES, or an active control. We imposed no language restriction.

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Pilot Randomized Trial of Progressive Resistance Exercise Augmented by Neuromuscular Electrical Stimulation for People With Multiple Sclerosis Who Use Walking Aids

Cited by 34 publications

References 40 publications

Important considerations for feasibility studies in physical activity research involving persons with multiple sclerosis: a scoping systematic review and case study

Important considerations for feasibility studies in physical activity research involving persons with multiple sclerosis: a scoping systematic review and case study

Psychometric Properties of a Clinical Strength Assessment Protocol in People with Multiple Sclerosis

Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease

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