Neuromuscular adaptations to long-term progressive resistance training translates to improved functional capacity for people with multiple sclerosis and is maintained at follow-up

Background: Progressive resistance training (PRT) is acknowledged to effectively improve muscle strength for people with multiple sclerosis (PwMS), but diverging results exist regarding whether such improvements translates to improved functional capacity, possibly relating to insufficient duration and/or intensity in some previous studies. Objective: The purpose of this study was to evaluate potential changes in functional capacity and neuromuscular function after 24 weeks of supervised PRT, and whether improvements are maintained after an additional 24 weeks of self-guided exercise. Methods: This study was a randomised controlled trial, with a training group and a waitlist group undergoing supervised PRT for 24 weeks initially or after 24 weeks of habitual lifestyle, respectively. Functional capacity, isometric muscle strength of knee extensors and flexors, neural drive and thigh muscle cross-sectional area was measured at baseline, after 24 and 48 weeks. Results: The training group significantly improved neuromuscular function of the knee extensors and flexors, which translated to improvements in functional capacity. Furthermore, the improved functional capacity was maintained after 24 weeks of self-guided physical activity. The waitlist group produced similar patterns of changes after PRT. Conclusion: Compelling evidence is provided, that PRT performed over sufficiently long periods, improves functional capacity, likely due to neuromuscular adaptations.

Download Full-text

Multiple sclerosis and progressive resistance training: a systematic review

Multiple Sclerosis Journal ◽

10.1177/1352458512437418 ◽

2012 ◽

Vol 18 (9) ◽

pp. 1215-1228 ◽

Cited By ~ 129

Author(s):

T Kjølhede ◽

K Vissing ◽

U Dalgas

Keyword(s):

Multiple Sclerosis ◽

Resistance Training ◽

Muscle Strength ◽

Functional Capacity ◽

Morphological Changes ◽

Future Research ◽

Progressive Resistance Training ◽

Underlying Mechanisms ◽

Progressive Resistance

Recently progressive resistance training (PRT) has been recognised as an effective tool in the rehabilitation of persons with multiple sclerosis (MS). The objective of this study was to systematically review the literature of PRT studies for persons with MS. A comprehensive literature search (PubMed, SveMed+, Embase, Cochrane, PEDro, SPORTDiscus and Bibliotek.dk) was conducted. Identified papers were rated according to the PEDro-scale. Sixteen studies were included and scored between 3 and 8 of 11 total points on the PEDro-scale, showing a general lack of blinding. Strong evidence regarding the beneficial effect of PRT on muscle strength was observed. Regarding functional capacity, balance and self-reported measures (fatigue, quality of life and mood) evidence is less strong, but the tendency is overall positive. Indications of an effect on underlying mechanisms such as muscle morphological changes, neural adaptations and cytokines also exist, but the studies investigating these aspects are few and inconclusive. PRT has a positive effect on muscle strength for persons with MS. Heterogeneous results exist regarding the effect on functional capacity and self-reported measures probably because of differences in training protocols, samples sizes, type and severity of MS. The area of underlying mechanisms deserves more attention in future research.

Download Full-text

Fatigue, mood and quality of life improve in MS patients after progressive resistance training

Multiple Sclerosis Journal ◽

10.1177/1352458509360040 ◽

2010 ◽

Vol 16 (4) ◽

pp. 480-490 ◽

Cited By ~ 129

Author(s):

U. Dalgas ◽

E. Stenager ◽

J. Jakobsen ◽

T. Petersen ◽

HJ Hansen ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Resistance Training ◽

Beneficial Effect ◽

Control Group ◽

Progressive Resistance Training ◽

Multiple Sclerosis Patients ◽

Progressive Resistance

Fatigue occurs in the majority of multiple sclerosis patients and therapeutic possibilities are few. Fatigue, mood and quality of life were studied in patients with multiple sclerosis following progressive resistance training leading to improvement of muscular strength and functional capacity. Fatigue (Fatigue Severity Scale, FSS), mood (Major Depression Inventory, MDI) and quality of life (physical and mental component scores, PCS and MCS, of SF36) were scored at start, end and follow-up of a randomized controlled clinical trial of 12 weeks of progressive resistance training in moderately disabled (Expanded Disability Status Scale, EDSS: 3—5.5) multiple sclerosis patients including a Control group ( n = 15) and an Exercise group ( n = 16). Fatigue (FSS > 4) was present in all patients. Scores of FSS, MDI, PCS—SF36 and MCS—SF36 were comparable at start of study in the two groups. Fatigue improved during exercise by —0.6 (95% confidence interval (CI) —1.4 to 0.4) a.u. vs. 0.1 (95% CI —0.4 to 0.6) a.u. in controls ( p = 0.04), mood improved by —2.4 (95% CI —4.1 to 0.7) a.u. vs. 1.1 (—1.2 to 3.4) a.u. in controls ( p = 0.01) and quality of life (PCS—SF36) improved by 3.5 (95% CI 1.4—5.7) a.u. vs. —1.0 (95% CI —3.4—1.4) a.u. in controls ( p = 0.01). The beneficial effect of progressive resistance training on all scores was maintained at follow-up after further 12 weeks. Fatigue, mood and quality of life all improved following progressive resistance training, the beneficial effect being maintained for at least 12 weeks after end of intervention.

Download Full-text

Evidence of Rehabilitative Impact of Progressive Resistance Training (PRT) Programs in Parkinson Disease: An Umbrella Review

Parkinson s Disease ◽

10.1155/2020/9748091 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

T. Paolucci ◽

S. Sbardella ◽

C. La Russa ◽

F. Agostini ◽

M. Mangone ◽

...

Keyword(s):

Resistance Training ◽

Muscle Strength ◽

Parkinson Disease ◽

Systematic Reviews ◽

Cochrane Library ◽

Progressive Resistance Training ◽

Umbrella Review ◽

Positive Effects ◽

Meta Analyses ◽

Progressive Resistance

Parkinson disease (PD) is a chronic neurodegenerative condition that leads to progressive disability. PD-related reductions in muscle strength have been reported to be associated with lower functional performance and balance confidence with an increased risk of falls. Progressive resistance training (PRT) improves strength, balance, and functional abilities. This umbrella review examines the efficacy of PRT regarding muscular strength in PD patients. The PubMed, PEDro, Scopus, and Cochrane Library databases were searched from January 2009 to August 2019 for systematic reviews and meta-analyses conducted in English. The populations included had diagnoses of PD and consisted of males and females aged >18 years old. Outcomes measured were muscle strength and enhanced physical function. Eight papers (six systematic reviews and meta-analyses and two systematic reviews) were considered relevant for qualitative analysis. In six of the eight studies, the reported severity of PD was mild to moderate. Each study analyzed how PRT elicited positive effects on muscle strength in PD patients, suggesting 10 weeks on average of progressive resistance exercises for the upper and lower limbs two to three times per week. However, none of the studies considered the postworkout follow-up, and there was no detailed evidence about the value of PRT in preventing falls. The possibility of PRT exercises being effective for increasing muscle strength in patients with PD, but without comorbidities or severe disability, is discussed. Overall, this review suggests that PRT should be included in rehabilitation programs for PD patients, in combination with balance training for postural control and other types of exercise, in order to preserve cardiorespiratory fitness and improve endurance in daily life activities.

Download Full-text

Cytokine Levels After Eight Weeks of Progressive Resistance Training in Multiple Sclerosis Patients

Medicine & Science in Sports & Exercise ◽

10.1097/00005768-200405001-00714 ◽

2004 ◽

Vol 36 (Supplement) ◽

pp. S150

Author(s):

Vanessa Castellano ◽

Sean C. McCoy ◽

Lesley J. White

Keyword(s):

Multiple Sclerosis ◽

Resistance Training ◽

Progressive Resistance Training ◽

Cytokine Levels ◽

Multiple Sclerosis Patients ◽

Progressive Resistance

Download Full-text

Effects of long-term resistance training and simultaneous electro-stimulation on muscle strength and functional mobility in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458510391339 ◽

2010 ◽

Vol 17 (4) ◽

pp. 468-477 ◽

Cited By ~ 68

Author(s):

Tom Broekmans ◽

Machteld Roelants ◽

Peter Feys ◽

Geert Alders ◽

Domien Gijbels ◽

...

Keyword(s):

Multiple Sclerosis ◽

Resistance Training ◽

Muscle Strength ◽

Controlled Trial ◽

Knee Extensor ◽

Functional Mobility ◽

Knee Extensors ◽

Strength Analysis ◽

Control Group

Background: Resistance training studies in multiple sclerosis (MS) often use short intervention periods. Furthermore, training efficiency could be optimized by unilateral training and/or electrical stimulation. Objective: To examine the effect(s) of unilateral long-term (20 weeks) standardized resistance training with and without simultaneous electro-stimulation on leg muscle strength and overall functional mobility. Methods: A randomized controlled trial involving 36 persons with MS. At baseline (PRE) and after 10 (MID) and 20 (POST) weeks of standardized (ACSM) light to moderately intense unilateral leg resistance training (RESO, n = 11) only or resistance training with simultaneous electro-stimulation (RESE, n = 11, 100 Hz, biphasic symmetrical wave, 400 µs), maximal isometric strength of the knee extensors and flexors (45°, 90° knee angle) and dynamic (60–180°/s) knee-extensor strength was measured and compared with a control group (CON, n = 14). Functional mobility was evaluated using the Timed Get Up and Go, Timed 25 Foot Walk, Two-Minute Walk Test, Functional Reach and Rivermead Mobility Index. Results: Maximal isometric knee extensor (90°, MID: +10 ± 3%, POST: +10 ± 4%) in RESO and knee flexor (45°, POST: +7 ± 4%; 90°, POST: +9 ± 5%) in RESE strength increased ( p < 0.05) compared with CON but RESO and RESE did not differ. Also, impaired legs responded positively to resistance training (unilateral leg strength analysis) and functional reaching increased significantly in RESO (+18%) compared with CON. Dynamic muscle strength and the remaining functional mobility tests did not change. Conclusion: Long-term light to moderately intense resistance training improves muscle strength in persons with MS but simultaneous electro-stimulation does not further improve training outcome.

Download Full-text