1
|
Geßner A, Hartmann M, Trentzsch K, Stölzer-Hutsch H, Schriefer D, Ziemssen T. The Association of Age, Sex, and BMI on Lower Limb Neuromuscular and Muscle Mechanical Function in People with Multiple Sclerosis. Biomedicines 2024; 12:971. [PMID: 38790932 PMCID: PMC11117965 DOI: 10.3390/biomedicines12050971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
(1) Background: The countermovement jump (CMJ) on a force plate could be a sensitive assessment for detecting early lower-limb muscle mechanical deficits in the early stages of multiple sclerosis (MS). CMJ performance is known to be influenced by various anthropometric, physiological, and biomechanical factors, mostly investigated in children and adult athletes. Our aim was to investigate the association of age, sex, and BMI with muscle mechanical function using CMJ to provide a comprehensive overview of lower-limb motor function in people with multiple sclerosis (pwMS). (2) Methods: A cross-sectional study was conducted with pwMS (N = 164) and healthy controls (N = 98). All participants performed three maximal CMJs on a force plate. Age, sex, and BMI were collected from all participants. (3) Results: Significant age, sex, and BMI effects were found for all performance parameters, flight time, and negative and positive power for pwMS and HC, but no significant interaction effects with the group (pwMS, HC) were detected. The highest significant effects were found for sex on flight time (η2 = 0.23), jump height (η2 = 0.23), and positive power (η2 = 0.13). PwMS showed significantly lower CMJ performance compared to HC in middle-aged (31-49 years), with normal weight to overweight and in both women and men. (4) Conclusions: This study showed that age, sex, and BMI are associated with muscle mechanical function in pwMS and HC. These results may be useful in developing reference values for CMJ. This is a crucial step in integrating CMJ into the diagnostic assessment of people with early MS and developing individualized and effective neurorehabilitative therapy.
Collapse
Affiliation(s)
| | | | | | | | | | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (A.G.); (M.H.); (K.T.); (H.S.-H.); (D.S.)
| |
Collapse
|
2
|
Zanotto T, Kumar DP, Tabatabaei A, Lynch SG, He J, Herda TJ, Devos H, Thiyagarajan R, Chaves L, Seldeen K, Troen BR, Sosnoff JJ. Multimodal exercise training to reduce frailty in people with multiple sclerosis: study protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 2024; 10:65. [PMID: 38650042 PMCID: PMC11034042 DOI: 10.1186/s40814-024-01496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/14/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Frailty, a syndrome characterized by decreased reserve and resistance to stressors across multiple physiologic systems, is highly prevalent in people living with multiple sclerosis (pwMS), independent of age or disability level. Frailty in MS is strongly associated with adverse clinical outcomes, such as falls, and may aggravate MS-related symptoms. Consequently, there is a pressing necessity to explore and evaluate strategies to reduce frailty levels in pwMS. The purpose of this pilot randomized controlled trial (RCT) will be to examine the feasibility and preliminary efficacy of a multimodal exercise training program to reduce frailty in pwMS. METHODS A total of 24 participants will be randomly assigned to 6 weeks of multimodal exercise or to a waitlist control group with a 1:1 allocation. PwMS aged 40-65 years and living with frailty will be eligible. The multimodal exercise program will consist of cognitive-motor rehabilitation (i.e., virtual reality treadmill training) combined with progressive, evidence-based resistance training. At baseline and post-intervention, participants will complete the Evaluative Frailty Index for Physical Activity (EFIP), measures of fall risk, and quality of life. Frailty-related biomarkers will also be assessed. In addition, the feasibility of the multimodal exercise program will be systematically and multidimensionally evaluated. DISCUSSION To date, no RCT has yet been conducted to evaluate whether targeted exercise interventions can minimize frailty in MS. The current study will provide novel data on the feasibility and preliminary efficacy of multimodal exercise training as a strategy for counteracting frailty in pwMS. TRIAL REGISTRATION ClinicalTrials.gov, NCT06042244 (registered in September 2023).
Collapse
Affiliation(s)
- Tobia Zanotto
- Department of Occupational Therapy Education, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
- Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA.
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Danya Pradeep Kumar
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Abbas Tabatabaei
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sharon G Lynch
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jianghua He
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Trent J Herda
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, KS, USA
| | - Hannes Devos
- Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ramkumar Thiyagarajan
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Geriatrics, Department of Internal Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Lee Chaves
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Geriatrics, Department of Internal Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Research Service, Kansas City Veterans Affairs Healthcare System, Kansas City, MO, USA
| | - Kenneth Seldeen
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Geriatrics, Department of Internal Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Research Service, Kansas City Veterans Affairs Healthcare System, Kansas City, MO, USA
| | - Bruce R Troen
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Division of Geriatrics, Department of Internal Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- Research Service, Kansas City Veterans Affairs Healthcare System, Kansas City, MO, USA
| | - Jacob J Sosnoff
- Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education and Service, Kansas City, KS, USA
- Landon Center on Aging, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
| |
Collapse
|
3
|
Maroto-Izquierdo S, Mulero P, Menéndez H, Pinto-Fraga J, Lista S, Santos-Lozano A, Téllez N. Pumping up the Fight against Multiple Sclerosis: The Effects of High-Intensity Resistance Training on Functional Capacity, Muscle Mass, and Axonal Damage. Healthcare (Basel) 2024; 12:837. [PMID: 38667599 PMCID: PMC11050496 DOI: 10.3390/healthcare12080837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Resistance training (RT) has been recognized as a beneficial non-pharmacological intervention for multiple sclerosis (MS) patients, but its impact on neurodegeneration is not fully understood. This study aimed to investigate the effects of high-intensity RT on muscle mass, strength, functional capacity, and axonal damage in MS patients. METHODS Eleven relapsing-remitting MS patients volunteered in this within-subject counterbalanced intervention study. Serum neurofilament light-chain (NfL) concentration, vastus lateralis thickness (VL), timed up-and-go test (TUG), sit-to-stand test (60STS), and maximal voluntary isometric contraction (MVIC) were measured before and after intervention. Participants performed 18 sessions of high-intensity RT (70-80% 1-RM) over 6 weeks. RESULTS Significant (p < 0.05) differences were observed post-intervention for VL (ES = 2.15), TUG (ES = 1.98), 60STS (ES = 1.70), MVIC (ES = 1.78), and NfL (ES = 1.43). Although moderate correlations between changes in VL (R = 0.434), TUG (R = -0.536), and MVIC (R = 0.477) and changes in NfL were observed, only the correlation between VL and MVIC changes was significant (R = 0.684, p = 0.029). CONCLUSIONS A 6-week RT program significantly increased muscle mass, functional capacity, and neuromuscular function while also decreasing serum NfL in MS patients. These results suggest the effectiveness of RT as a non-pharmacological approach to mitigate neurodegeneration while improving functional capacity in MS patients.
Collapse
Affiliation(s)
- Sergio Maroto-Izquierdo
- i+HeALTH, Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain
| | - Patricia Mulero
- Neurology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Héctor Menéndez
- i+HeALTH, Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain
| | - José Pinto-Fraga
- i+HeALTH, Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain
| | - Simone Lista
- i+HeALTH, Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain
| | - Alejandro Santos-Lozano
- i+HeALTH, Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), 47012 Valladolid, Spain
| | - Nieves Téllez
- Neurology Department, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| |
Collapse
|
4
|
Ramari C, Awadia Z, Bansi J, Casey B, Feys P, Pilutti LA, Sandroff BM, Paul L. The MoxFo initiative - outcomes: Outcome measures in studies of exercise training in multiple sclerosis; scoping review of reviews and classification according to the ICF framework. Mult Scler 2023; 29:1578-1594. [PMID: 37880966 DOI: 10.1177/13524585231204451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
BACKGROUND The number of published studies of exercise training in multiple sclerosis (MS) has grown exponentially with increasing numbers of outcomes capturing exercise effects. This has complicated the selection of relevant indicators and interpretation of intervention effects. OBJECTIVES The Outcomes subgroup of the MoXFo initiative aimed to (1) identify outcome measures and biomarkers in studies of exercise training in MS; (2) systematically map retrieved outcomes to International Classification of Functioning, Disability and Health (ICF) categories; (3) identify gaps where relevant ICF categories have been omitted. METHODS Electronic databases and registers were searched from 2010 to July 2020 to identify systematic reviews or meta-analyses of controlled trials of exercise training on any outcome in MS. Retrieved outcomes/biomarkers were mapped to the corresponding ICF category. RESULTS Eighty-one review articles reporting 235 different outcomes were included. The outcomes corresponded to 15 chapters and 45 categories within the ICF. Outcomes mapped primarily to body function (30 categories) and activities and participation (9 categories) components. Few outcomes mapped to body structures (2 categories) or environmental factors (1 category). CONCLUSION This sets the stage to develop a resource for researchers/clinicians that will aid in the selection of appropriate outcomes/biomarkers when examining exercise effects in MS.
Collapse
Affiliation(s)
- Cintia Ramari
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- University MS Center (UMSC), Hasselt, Belgium
| | - Zain Awadia
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Jens Bansi
- Physical Activity for Health (PAfH) Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | | | - Peter Feys
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- University MS Center (UMSC), Hasselt, Belgium
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Brian M Sandroff
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, West Orange, NJ, USA
| | - Lorna Paul
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| |
Collapse
|
5
|
Reina-Gutiérrez S, Meseguer-Henarejos AB, Torres-Costoso A, Álvarez-Bueno C, Cavero-Redondo I, Núñez de Arenas-Arroyo S, Guzmán-Pavón MJ, Sánchez-López M, Martínez-Vizcaíno V. Effect of different types of exercise on fitness in people with multiple sclerosis: A network meta-analysis. Scand J Med Sci Sports 2023; 33:1916-1928. [PMID: 37226414 DOI: 10.1111/sms.14407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND It is assumed that people with multiple sclerosis (MS) who participate in programs of physical exercise improve their physical fitness. OBJECTIVE The aim of this network meta-analysis (NMA) was to analyze the effect of different types of exercise on muscular fitness and cardiorespiratory fitness (CRF) among people with MS and to determine the best type of exercise according to disease severity. METHODS MEDLINE, the Physiotherapy Evidence Database, the Cochrane Library, SPORTDiscus, Scopus, and Web of Science were searched from inception to April 2022 to identify randomized controlled trials (RCTs) concerning the effect of physical exercise on fitness in people with MS. We ranked the types of physical exercise by calculating the surface under the cumulative ranking (SUCRA). RESULTS We included 72 RCTs involving 2543 MS patients in this NMA. A ranking of five types of physical exercise (aerobic, resistance, combined [aerobic and resistance], sensorimotor training, and mind-body exercises) was achieved. Combined and resistance training had the highest effect sizes (0.94, 95% CI 0.47, 1.41, and 0.93, 95% CI 0.57, 1.29, respectively) and the highest SUCRA (86.2% and 87.0%, respectively) for muscular fitness. The highest effect size (0.66, 95% CI 0.34, 0.99) and SUCRA (86.9%) for CRF was for aerobic exercise. CONCLUSIONS Combined and resistance training seem to be the most effective exercises to improve muscular fitness and aerobic exercise for CRF in people with MS.
Collapse
Affiliation(s)
- Sara Reina-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | - Ana Torres-Costoso
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
- Rehabilitation in Health Research Center (CIRES), Universidad de las Americas, Santiago, Chile
| | | | | | - Mairena Sánchez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- School of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| |
Collapse
|
6
|
Ispoglou T, Ferentinos P, Prokopidis K, Blake C, Aldrich L, Elia A, Lees M, Hind K. Exploring the impact of exercise and essential amino acid plus cholecalciferol supplementation on physical fitness and body composition in multiple sclerosis: A case study. Clin Case Rep 2023; 11:e7548. [PMID: 37323260 PMCID: PMC10264925 DOI: 10.1002/ccr3.7548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/24/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
Key Clinical Message In MS patients, especially those frail or malnourished, combining home-based exercise twice weekly with essential amino acids and vitamin D may improve body composition, strength, and physical performance, enabling long-term functional improvements. Abstract Multiple sclerosis (MS) is associated with reduced bone and muscle strength and function. We aimed to investigate the effectiveness of a 24-week intervention in a 57-year-old frail female with MS. The participant completed a 2×/week exercise intervention and ingested 2×/day a supplement containing 7.5 g essential amino acids and 500 IU cholecalciferol. Body composition, 6-m gait speed (GS), handgrip strength (HGS), 30-sec arm-curl test (30ACT), 6-min walking test (6MWT), 30-sec chair-stand test (30CST), and plasma concentrations of 25-hydroxyvitamin D3 [25(OH)D3], insulin-like growth factor 1 (IGF-1), and amino acids were assessed at baseline, and at Weeks 12 and 24. Plasma 25(OH)D3 increased from 23.2 to 41.3 ng/mL and IGF-1 from 131.6 to 140.7 ng/mL from baseline to post-intervention. BMI, total lean tissue mass (LTM), fat mass, bone mineral content, and the sum of 17 amino acids increased by 3.8, 1.0, 3.5, 0.2, and 19%, respectively, at Week 24. There were clinically significant increases in regional LTM (6.9% arms and 6.3% legs) and large increases in GS (67.3%), dominant HGS (31.5%), non-dominant HGS (11.8%), dominant 30ACT (100%), non-dominant 30ACT (116.7%), 6MWT (125.6%), and 30CST (44.4%). The current intervention was effective in improving components of physical fitness and body composition in a female with MS.
Collapse
Affiliation(s)
| | | | | | - Cameron Blake
- Carnegie School of SportLeeds Beckett UniversityLeedsUK
| | - Luke Aldrich
- Carnegie School of SportLeeds Beckett UniversityLeedsUK
| | - Antonis Elia
- Division of Environmental PhysiologyRoyal Institute of TechnologyStockholmSweden
| | - Matthew Lees
- Faculty of Kinesiology and Physical EducationUniversity of TorontoTorontoOntarioCanada
| | - Karen Hind
- Wolfson Research Institute for Health and Well‐beingDurhamUK
| |
Collapse
|
7
|
Bouquiaux O, Beaudart C, Thibaut A, Detal T, Marsala L, Dorban G, Kaux J. Beneficial effects of a supervised and individualized training circuit on physical capacities and quality of life of patients suffering from multiple sclerosis. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Hortobágyi T, Vetrovsky T, Balbim GM, Sorte Silva NCB, Manca A, Deriu F, Kolmos M, Kruuse C, Liu-Ambrose T, Radák Z, Váczi M, Johansson H, Dos Santos PCR, Franzén E, Granacher U. The impact of aerobic and resistance training intensity on markers of neuroplasticity in health and disease. Ageing Res Rev 2022; 80:101698. [PMID: 35853549 DOI: 10.1016/j.arr.2022.101698] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the effects of low- vs. high-intensity aerobic and resistance training on motor and cognitive function, brain activation, brain structure, and neurochemical markers of neuroplasticity and the association thereof in healthy young and older adults and in patients with multiple sclerosis, Parkinson's disease, and stroke. DESIGN Systematic review and robust variance estimation meta-analysis with meta-regression. DATA SOURCES Systematic search of MEDLINE, Web of Science, and CINAHL databases. RESULTS Fifty studies with 60 intervention arms and 2283 in-analyses participants were included. Due to the low number of studies, the three patient groups were combined and analyzed as a single group. Overall, low- (g=0.19, p = 0.024) and high-intensity exercise (g=0.40, p = 0.001) improved neuroplasticity. Exercise intensity scaled with neuroplasticity only in healthy young adults but not in healthy older adults or patient groups. Exercise-induced improvements in neuroplasticity were associated with changes in motor but not cognitive outcomes. CONCLUSION Exercise intensity is an important variable to dose and individualize the exercise stimulus for healthy young individuals but not necessarily for healthy older adults and neurological patients. This conclusion warrants caution because studies are needed that directly compare the effects of low- vs. high-intensity exercise on neuroplasticity to determine if such changes are mechanistically and incrementally linked to improved cognition and motor function.
Collapse
Affiliation(s)
- Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen Medical Center, Groningen, the Netherlands; Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary; Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Hungary; Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany; Hungarian University of Sports Science, Department of Kinesiology, Budapest, Hungary.
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Guilherme Moraes Balbim
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Nárlon Cássio Boa Sorte Silva
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy; Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, Sassari, Italy
| | - Mia Kolmos
- Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Christina Kruuse
- Neurovascular Research Unit, Department of Neurology, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Zsolt Radák
- Research Center of Molecular Exercise Science, Hungarian University of Sport Science, Budapest, Hungary
| | - Márk Váczi
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Hungary
| | - Hanna Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | | | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| |
Collapse
|
9
|
Gooch H, Hill J, Clegg A. Strength training for people with multiple sclerosis and the current recommendations. BRITISH JOURNAL OF NEUROSCIENCE NURSING 2021; 17:S32-S41. [PMID: 38736990 PMCID: PMC7615946 DOI: 10.12968/bjnn.2021.17.sup3.s32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Recent guidelines recommend strength and conditioning training for patients with multiple sclerosis (MS). This article evaluates and summarises four systematic reviews examining strength training for people with MS and examines if these reviews substantiate these current guidelines.
Collapse
Affiliation(s)
- Helen Gooch
- Clinical Lead Physiotherapist for Neurology, Core Therapies Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - James Hill
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - Andrew Clegg
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| |
Collapse
|
10
|
Momsen AMH, Ørtenblad L, Maribo T. Effective rehabilitation interventions and participation among people with multiple sclerosis: an overview of reviews. Ann Phys Rehabil Med 2021; 65:101529. [PMID: 33940247 DOI: 10.1016/j.rehab.2021.101529] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/02/2021] [Accepted: 03/20/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is the most common cause of non-traumatic disability in people aged 10 to 65 years. Evidence exists for the effectiveness of multidisciplinary rehabilitation and exercise. However, the effectiveness of other rehabilitation approaches in MS needs further evaluation. OBJECTIVE We aimed to systematically synthesize and evaluate knowledge on effectiveness of rehabilitation interventions and determinants for participation among people with MS (pwMS) to inform clinical guidelines on rehabilitation. METHODS Joanna Briggs Institute methodology was used. PubMed, Embase, CINAHL, PsycINFO and Web of Science were searched for reviews, systematic reviews, meta-analyses, and meta-syntheses published during 2009-2019. All types of rehabilitation interventions provided to pwMS at any time and in all settings were eligible. Two reviewers independently screened and extracted data. The most recently published reviews on mixed and specific modalities were included. The findings were reported in a narrative summary and a mixed-methods analysis. RESULTS Among 108 eligible reviews, 6 qualitative or mixed-methods reviews and 66 quantitative reviews were included (total pwMS >90,000). This overview provides solid evidence for the effectiveness of a spectrum of modalities. Among the modalities, there was strong evidence for the effectiveness of multidisciplinary, cognitive and exercise approaches, physiotherapy, and occupational therapy, including full body training on functioning, and participation outcomes. Employment significantly affected quality of life; thus, vocational rehabilitation should be initiated early. Healthcare professionals should identify personal factors including relations and coping, and the rehabilitation process should involve partners or close family. CONCLUSIONS The mixed-methods analysis revealed insufficient consensus between the perspectives of pwMS on their rehabilitation and reported effects, indicating that further research should target the experiences of pwMS. Furthermore, rehabilitation should be patient-centred, focus on the complexity of needs, and be organised and performed by an experienced multidisciplinary team. Evidence-based rehabilitation should be initiated early after pwMS are diagnosed and follow international guidelines. Database registration. PROSPERO ID (CRD42020152422).
Collapse
Affiliation(s)
- Anne-Mette Hedeager Momsen
- DEFACTUM - Social & Health Services and Labour Market, Corporate Quality, Central Denmark Region, Aarhus, Denmark.
| | - Lisbeth Ørtenblad
- DEFACTUM - Social & Health Services and Labour Market, Corporate Quality, Central Denmark Region, Aarhus, Denmark
| | - Thomas Maribo
- DEFACTUM - Social & Health Services and Labour Market, Corporate Quality, Central Denmark Region, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
11
|
Hortobágyi T, Granacher U, Fernandez-Del-Olmo M, Howatson G, Manca A, Deriu F, Taube W, Gruber M, Márquez G, Lundbye-Jensen J, Colomer-Poveda D. Functional relevance of resistance training-induced neuroplasticity in health and disease. Neurosci Biobehav Rev 2020; 122:79-91. [PMID: 33383071 DOI: 10.1016/j.neubiorev.2020.12.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 01/13/2023]
Abstract
Repetitive, monotonic, and effortful voluntary muscle contractions performed for just a few weeks, i.e., resistance training, can substantially increase maximal voluntary force in the practiced task and can also increase gross motor performance. The increase in motor performance is often accompanied by neuroplastic adaptations in the central nervous system. While historical data assigned functional relevance to such adaptations induced by resistance training, this claim has not yet been systematically and critically examined in the context of motor performance across the lifespan in health and disease. A review of muscle activation, brain and peripheral nerve stimulation, and imaging data revealed that increases in motor performance and neuroplasticity tend to be uncoupled, making a mechanistic link between neuroplasticity and motor performance inconclusive. We recommend new approaches, including causal mediation analytical and hypothesis-driven models to substantiate the functional relevance of resistance training-induced neuroplasticity in the improvements of gross motor function across the lifespan in health and disease.
Collapse
Affiliation(s)
- Tibor Hortobágyi
- Center for Human Movement Sciences, University of Groningen, University Medical CenterGroningen, Groningen, Netherlands.
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - Miguel Fernandez-Del-Olmo
- Area of Sport Sciences, Faculty of Sports Sciences and Physical Education, Center for Sport Studies, King Juan Carlos University, Madrid, Spain
| | - Glyn Howatson
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK; Water Research Group, North West University, Potchefstroom, South Africa
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Wolfgang Taube
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
| | - Markus Gruber
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Konstanz, Germany
| | - Gonzalo Márquez
- Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Jesper Lundbye-Jensen
- Movement & Neuroscience, Department of Nutrition, Exercise & Sports Department of Neuroscience, University of Copenhagenk, Faculty of Health Science, Universidad Isabel I, Burgos, Spain
| | | |
Collapse
|
12
|
Portilla-Cueto K, Medina-Pérez C, Romero-Pérez EM, Hernández-Murúa JA, Patrocinio de Oliveira CE, de Souza-Teixeira F, González-Bernal JJ, Vila-Chã C, de Paz JA. Reference Values for Isometric, Dynamic, and Asymmetry Leg Extension Strength in Patients with Multiple Sclerosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8083. [PMID: 33147859 PMCID: PMC7662302 DOI: 10.3390/ijerph17218083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 12/25/2022]
Abstract
Having recognized the value of resistance training in patients with multiple sclerosis (PwMS), there are a lack of lower limb normative reference values for one repetition maximum (1RM) and maximal voluntary isometric contraction (MVIC) in this population. Hence, the purposes of this study were to provide reference values for 1RM and MVIC of knee extensors in PwMS across the disability spectrum and to examine knee extension strength asymmetry. Three hundred and ninety PwMS participated in the study, performing MVIC and 1RM tests of bilateral (both legs together at once) and unilateral (each leg singly) knee extensors. There was no difference in 1RM according to the disease course of MS, but there was according to the degree of neurological disability, being more preserved in those with a lower degree of disability. MVIC tends to be higher in patients with relapsing-remitting MS respect those with progressive MS, and in patients with lower levels of neurological disability. Asymmetry above the values considered normal in 1RM was present in 20-60% of patients and 56-79% in the MVIC test, depending on the type of MS and tended to be lower in those with less disability. Reference values are given by quartiles for 1RM, MVIC, and asymmetry.
Collapse
Affiliation(s)
- Kora Portilla-Cueto
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain; (K.P.-C.); (J.A.d.P.)
| | | | | | | | | | - Fernanda de Souza-Teixeira
- Exercise and Neuromuscular System Research Group, Superior School of Physical Education, Federal University of Pelotas, 96010-610 Pelotas, Brazil;
| | | | - Carolina Vila-Chã
- Polytechnic Institute of Guarda, 6300-559 Guarda, Portugal;
- Research Center in Sports Sciences, Health and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - José Antonio de Paz
- Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain; (K.P.-C.); (J.A.d.P.)
| |
Collapse
|
13
|
Manca A, Ventura L, Martinez G, Aiello E, Deriu F. Contralateral Strength Training as Preparation for Direct Strength Training in a Patient With Unilateral Foot-Drop Because of Multiple Sclerosis: A Case Report. Phys Ther 2020; 100:1816-1824. [PMID: 32691064 DOI: 10.1093/ptj/pzaa127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 12/13/2019] [Accepted: 05/05/2020] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Direct strength training (DST) is effective in managing unilateral weakness in people with multiple sclerosis (MS). Its feasibility, however, is considerably reduced if one limb is too compromised to train. In this case, contralateral strength training (CST) of the unaffected side to induce a strength transfer to the untrained homologous muscles can help to establish a strength baseline in the weaker limb, eventually allowing direct training. Limited effects for CST, however, have been reported on patient functioning. We tested the effects on dynamometric, electromyographic, and functional outcomes of a sequential combination of CST and DST of the ankle dorsiflexors in a case of MS-related foot-drop. METHODS A 56-year-old man diagnosed with relapsing-remitting MS exhibited severe weakness of the right dorsiflexors impairing functional dorsiflexion. The intervention consisted of a 6-week CST of the unaffected dorsiflexors followed by 2 consecutive 6-week DST cycles targeting the weaker dorsiflexors. RESULTS At baseline, the participant could not dorsiflex his right ankle but could do so after CST. Maximal strength of the affected dorsiflexors increased by 80% following CST, by 31.1% following DST-1, and by a further 44.6% after DST-2. Neuromuscular recruitment was found progressively increased, with the largest changes occurring after DST-1. Improvements in mobility and walking speed were also detected, although plantar flexors' spasticity on the Modified Ashworth Scale increased from 1+ to 2. CONCLUSION In this case, the sequential combination of CST and DST proved a feasible approach to manage severe unilateral weakness in a patient who was not able, at least initially, to dorsiflex his weaker ankle. In this perspective, CST may prime a minimum gain in strength necessary to allow subsequent direct training.
Collapse
Affiliation(s)
- Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Lucia Ventura
- Department of Biomedical Sciences, University of Sassari
| | | | - Elena Aiello
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/b, Sassari 07100, Italy. Address all correspondence to Dr Deriu at:
| |
Collapse
|