The importance of lower-extremity muscle strength for lower-limb functional capacity in multiple sclerosis: Systematic review

Context: Blood flow–restricted training (BFRT) has been suggested to treat lower extremity muscle weakness. The efficacy of BFRT for muscle problems related to knee pathology is unclear. Objective: To determine whether BFRT (1) improves muscle strength and cross-sectional area (CSA) for chronic knee-related lower extremity atrophy and (2) prevents muscle atrophy after knee surgery. Data Sources: A systematic review of the literature from 1974 to 2017 was conducted using the PubMed and Cochrane databases. Study Selection: Controlled trials that used BFRT to treat chronic knee-related lower extremity muscle atrophy or to prevent muscle atrophy after knee surgery that measured the effects on quadriceps or hamstrings muscle strength or CSA were included. Study Design: Systematic review. Level of Evidence: Level 2. Data Extraction: Data were extracted as available from 9 studies (8 level 1, 1 level 2). Assessment of study quality was rated using the Physiotherapy Evidence Database or Methodological Index for Non-Randomized Studies instruments. Results: BFRT was used after anterior cruciate ligament reconstruction and routine knee arthroscopy and in patients with knee osteoarthritis or patellofemoral pain. There were a total of 165 patients and 170 controls. Vascular occlusion and exercise protocols varied; all studies except 1 incorporated exercises during occlusion, most of which focused on the quadriceps. Six of 7 studies that measured quadriceps strength reported statistically significant improvements after training. Few benefits in quadriceps CSA were reported. Hamstrings strength was only measured in 2 studies. There were no complications related to training. Conclusion: Published limited data show BFRT to be safe and potentially effective in improving quadriceps muscle strength in patients with weakness and atrophy related to knee pathology. The use of short-duration vascular occlusion and light-load resistance exercises appears safe after knee surgery or in arthritic knees. This treatment option requires further investigation to refine protocols related to cuff pressure and exercise dosage and duration.

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Impairments of Lower Extremity Muscle Strength and Balance in Childhood Cancer Patients and Survivors: A Systematic Review

Pediatric Hematology and Oncology ◽

10.3109/08880018.2015.1079756 ◽

2015 ◽

Vol 32 (8) ◽

pp. 585-612 ◽

Cited By ~ 21

Author(s):

Regine Söntgerath ◽

Katharina Eckert

Keyword(s):

Systematic Review ◽

Muscle Strength ◽

Lower Extremity ◽

Childhood Cancer ◽

Cancer Patients ◽

Lower Extremity Muscle

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Associations Between Measures of Balance and Lower-Extremity Muscle Strength/Power in Healthy Individuals Across the Lifespan: A Systematic Review and Meta-Analysis

Sports Medicine ◽

10.1007/s40279-015-0390-z ◽

2015 ◽

Vol 45 (12) ◽

pp. 1671-1692 ◽

Cited By ~ 58

Author(s):

Thomas Muehlbauer ◽

Albert Gollhofer ◽

Urs Granacher

Keyword(s):

Systematic Review ◽

Muscle Strength ◽

Lower Extremity ◽

Meta Analysis ◽

Healthy Individuals ◽

Lower Extremity Muscle

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Muscle architecture and its relationship with lower extremity muscle strength in multiple sclerosis

Acta Neurologica Belgica ◽

10.1007/s13760-021-01768-1 ◽

2021 ◽

Author(s):

Zekiye İpek Katirci Kirmaci ◽

Tüzün Firat ◽

Hanifi Ayhan Özkur ◽

Ayşe Münife Neyal ◽

Abdurrahman Neyal ◽

...

Keyword(s):

Multiple Sclerosis ◽

Muscle Strength ◽

Lower Extremity ◽

Muscle Architecture ◽

Lower Extremity Muscle

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Effect of single and multi-joint lower extremity muscle strength on the functional capacity and ADL/IADL status in Japanese community-dwelling older adults

Nursing and Health Sciences ◽

10.1111/j.1442-2018.2007.00317.x ◽

2007 ◽

Vol 9 (3) ◽

pp. 168-176 ◽

Cited By ~ 23

Author(s):

Masako Azegami ◽

Masayoshi Ohira ◽

Kei Miyoshi ◽

Chise Kobayashi ◽

Minoru Hongo ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Lower Extremity ◽

Functional Capacity ◽

Community Dwelling ◽

Lower Extremity Muscle ◽

Community Dwelling Older Adults

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The effects of supervised versus home Pilates-based core stability training on lower extremity muscle strength and postural sway in people with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/13524585211012202 ◽

2021 ◽

pp. 135245852110122

Author(s):

Feray Güngör ◽

Ela Tarakci ◽

Zeynep Özdemir-Acar ◽

Aysun Soysal

Keyword(s):

Multiple Sclerosis ◽

Muscle Strength ◽

Lower Extremity ◽

Postural Control ◽

Postural Sway ◽

Core Stability ◽

Lower Extremity Muscle ◽

Home Based ◽

Stability Training ◽

Knee Muscle

Background: Pilates-based core stability training (PBCST) is a controlled form of exercise that may improve the transmission of torque from the upper extremities and trunk to the lower extremities by enabling the core muscles to activate effectively. Objectives: The aim of this study was to investigate the effects of PBCST given as supervised or home-based on lower extremity strength and postural control in multiple sclerosis. Methods: Fifty individuals were enrolled and randomly allocated into two groups. Primary outcome measures were knee muscle strength and postural sway in different conditions. The supervised group received PBCST 2 days per week for 8 weeks at the clinic, and the other group performed PBCST at home. Exercises were progressed every 2 weeks in both groups. Results: Between groups, the supervised group was mostly superior to the home group ( p < 0.05). A significant improvement was noted in all parameters in both groups, except some sub-parameters of postural sway in home PBCST ( p < 0.05). Conclusions: Supervised PBCST was determined to be more effective than home PBCST in improving strength, postural control, core stability, physical capacity, and fatigue. Although supervised training is the primary choice, home training can be recommended to patients who have limitations attending supervised sessions.

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