Brief report: Passive mechanical properties of gastrocnemius in multiple sclerosis and ankle contracture

Motor performance, motor impairments, and quality of life after eccentric resistance training in neurological populations: A systematic review and meta-analyses

BACKGROUND

Many overlapping factors impair motor performance and quality of life in neurological patients. Eccentric resistance training (ET) has potential benefits for improving motor performance and treating motor impairments better than some traditional rehabilitation approaches.

OBJECTIVE

To estimate the effect of ET in neurological settings.

METHODS

Seven databases were reviewed up to May 2022 according to PRSIMA guidelines to find randomized clinical trials involving adults with a neurological condition, who underwent ET as set by the American College of Sports Medicine. Motor performance (main outcome) was assessed as strength, power and capacities during activity. Secondary outcomes (impairments) were muscle structure, flexibility, muscle activity, tone, tremor, balance and fatigue. Tertiary outcomes were risk of fall, and self-reports of quality of life.

RESULTS

Ten trials were included, assessed using Risk of Bias 2.0 tool, and used to compute meta-analyses. Effective effects in favour of ET were found for strength and power, but not for capacities during activity. Mixed results were found for secondary and tertiary outcomes.

CONCLUSION

ET may be a promising intervention to better improve strength/power in neurological patients. More studies are needed to improve the quality of evidence underlying changes responsible for these results.

Eccentric exercise improves joint flexibility in adults: A systematic review update and meta-analysis

BACKGROUND

Eccentric exercise is thought to improve joint flexibility, but the size of the effect is not known. We aimed to quantify the overall effect of eccentric exercise on joint flexibility in adults.

DESIGN

Systematic review, meta-analysis.

DATA SOURCES

AMED, CINAHL, MEDLINE, EMBASE, SportDiscus.

PARTICIPANTS

Adults.

INTERVENTION

Eccentric exercise compared to no intervention or to a different intervention.

OUTCOME MEASURES

Joint range of motion or muscle fascicle length.

DATA EXTRACTION AND SYNTHESIS

Descriptive data of included trials and estimates of effect sizes were extracted. Standardised mean differences (SMD) of range of motion or fascicle length outcomes were meta-analysed using random effects models. Overall quality of evidence was assessed using the GRADE scale.

RESULTS

32 trials (1122 participants, 108 lost to follow-up) were included in the systematic review. The mean (SD) PEDro score was 5.2 (1.3). Four trials reported insufficient data for meta-analysis. Data from 27 trials (911 participants, 82 lost to follow-up) were meta-analysed. Eccentric exercise improved joint flexibility in adults (pooled random effects Hedges' g SMD = 0.54, 95% CI 0.34 to 0.74). The true effect size is different across studies and 50% of the variance in observed effects is estimated to reflect variance in true effects rather than sampling error (I² = 50%, Q = 67.6, d.f. = 34, p = 0.001). Overall quality of evidence ranged from 'low' to 'high'.

CONCLUSION

Eccentric exercise improves joint flexibility in adults. The overall standardised mean effect of eccentric exercise was moderately large, and the narrow width of the 95% confidence interval indicates the effect was estimated with good precision.

REGISTRATION

Open Science Foundation (https://osf.io/mkdqr); PROSPERO registration CRD42020151303.