Highlights Posturographic tests help to identify balance deterioration in people with multiple sclerosis with a homogeneous disease profile. The impairment of functional mobility, gait performance, and weaker leg condition are relevant symptoms to evaluate the physical activity limitations caused by disease progression in multiple sclerosis. Trunk stability is a relevant factor for functional capacity in multiple sclerosis, especially in balance demanding activities (i.e., standing with a small base of support, rising, turning, etc .).

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Background and objectives: Fatigue is one of the most disabling symptoms that limit daily life activities in persons with multiple sclerosis (pwMS). This study aimed to evaluate the effects of maximal strength training (MST) on perceived-fatigue and functional mobility in pwMS. Materials and Methods: 26 participants with MS were balanced according to their pre-intervention fatigue scores and distributed into an MST group (n = 13) and a control group (CG; n = 13). The MST group completed eight weeks using high loads, evaluating detraining after ten weeks. Quadriceps and hamstring isokinetic (QPTIK; HPTIK) and isometric (QPTIM; HPTIM) peak torques were assessed using an isokinetic dynamometer. Effect size differences were estimated with the Hedges’ g index (dg). Fatigue was evaluated through the Fatigue Severity Scale (FSS), while functional mobility was assessed via the Timed Up and Go Test (TUG). Results: The MST significantly improved all the strength measurements after the intervention (Δ6.43–29.55%; p < 0.05) compared to the control group. FSS showed a significant reduction (59.97%, dg = 5.41, large). The MST group also reduced the TUG time (19.69%; dg = 0.93, large) compared to the control group. Improvements caused by the intervention did not remain after a 10-week follow-up, with decreases in strength performance from 4.40% to 13.86% (dg = 0.24–0.56, small to moderate), 112.08% in the FSS (dg = −3.88, large), and 16.93% in TUG (dg = −1.07, large). Conclusions: MST (up to 90% 1RM) seems to be a feasible and useful way to obtain clinically relevant improvements in the perceived-fatigue symptoms and functional mobility. Still, symptom improvements decrease after a 10-week detraining period.

The aim of this systematic review is to analyze how, after additional trunk-focused training programs (ATEP), motor recovery after a stroke is modulated by potential effect modifiers. Twenty randomized controlled studies that carried out ATEP were included. Results showed moderate-to-high effects in favor of ATEP for trunk function, balance ability, gait performance, and functional mobility. Studies with a higher initial trunk impairment obtained a higher effect on trunk function and balance; studies with older participants had a higher effect on trunk function, limit of stability, and functional mobility, but not on balance ability. Older and more affected patients were, as well, those who started the intervention earlier, which was also linked with higher effects on trunk function, balance, and gait performance. Longer ATEP found a high effect on trunk function and balance ability. The potential effect modifiers seem to be important in the modulation of the effectiveness of ATEP and should be considered in the design of rehabilitation programs. Thus, since potential effect modifiers seem to modulate ATEP effectiveness, future studies should consider them in their experimental designs to better understand their impact on stroke rehabilitation.

Objective Research on muscle performance testing reliability in people with multiple sclerosis (PwMS) has focused on limb performance while less is known about trunk strength and endurance. The objective is to 1) establish test–retest reliability of Trunk Flexion, Lateral Flexion and Extension strength tests, and Plank, Side-Bridge and Biering-Sorensen endurance tests in PwMS and matched healthy controls (HC); 2) analyze known-groups validity of these tests in PwMS and HC; 3) to compare groups for side-to-side differences; 4) to describe the relationships between trunk performance and functional mobility tests. Methods Fifteen PwMS (median EDSS = 3) and 15 HC underwent two trunk isometric strength and endurance testing sessions. Mobility was evaluated by Timed Up-and-Go (TUG) test. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. Between-group differences in trunk performance were tested using the Student’s t-test for independent measures. Between-group differences in an asymmetry index were analyzed by independent t-test. Bivariate correlations between trunk tests and mobility were also examined. Results All trunk tests showed good-to-excellent relative reliability in both groups (ICC &gt; 0.71). Regarding absolute reliability, strength tests were associated with low intersession variability in both groups (MDC: MS, 11.23–36.45%; HC, 26.60–31.98%). Conversely, endurance tests showed higher variability scores in PwMS (MDC: MS, 69.55–116.50%; HC, 29.57–54.40%). PwMS displayed significantly lower trunk performance. Likewise, the asymmetry index showed significantly higher scores in PwMS for endurance assessment but not in strength tests. Significant correlations were detected in PwMS between TUG and several trunk tests (r = 0.63–0.70). Conclusions SEM and MDC scores revealed similar consistency and variability between groups for strength tests, while higher variability was observed for endurance tests in PwMS. Trunk strength tests are reliable and present discriminant validity to distinguish mildly-disabled PwMS from HC. Conversely, the high measurement error and variability of the endurance tests may hinder their application in intervention programs. Impact Determining the reliability and validity of the tests currently used to assess trunk function is of utter importance for PwMS (who not only show impaired trunk function but also wide fluctuations in performance) as it requires consistent and accurate measurements that are sensitive enough to detect minimal changes induced by rehabilitation.