Effects and optimal dosage of resistance training on strength, functional capacity, balance, general health perception, and fatigue in people with multiple sclerosis: a systematic review and meta-analysis

Andreu‐Caravaca, Luis; Ramos-Campo, Domingo Jesús; Chung, Linda H.; Martínez-Rodríguez, Alejandro; Rubio-Arias, Jacobo Á.

doi:10.1080/09638288.2022.2069295

Cited by 15 publications

(14 citation statements)

References 91 publications

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“…In previous studies on exercise and training in patients with PNP, aerobic training, strength training or a combination of both ( Otterman et al, 2011 ; Kluding et al, 2012 ; Nadi et al, 2017 ) have been practiced. In these studies, however, training intensities did not reach levels that are associated with a potential effect on strength in healthy ( American College of Sports Medicine position stand, 2009 ) or patients with other neurological disorders ( Hill et al, 2012 ; Mañago et al, 2019 ; Andreu-Caravaca et al, 2022 ). Interestingly, in two studies, strength and functional outcomes were not even investigated after the training period ( Kluding et al, 2012 ; Nadi et al, 2017 ).…”

Section: Discussionmentioning

confidence: 75%

“…In healthy adults, the improvement in outcomes of a training intervention depends on the length of the intervention and to an even greater extent, the training intensity ( Garber et al, 2011 ). Moreover, a review examining the effect of strength training in patients with multiple sclerosis reported that gait speed and endurance only improved in studies where intensities exceeded 70% of 1RM ( Mañago et al, 2019 ; Andreu-Caravaca et al, 2022 ). Also, a study examining the effect of strength training in stroke survivors only found improvement in strength and gait function when the training intensity exceeded 80% of 1RM ( Hill et al, 2012 ).…”

Section: Discussionmentioning

confidence: 99%

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Effect of strength training on functional outcomes and strength in patients with polyneuropathy: A scoping review

et al. 2023

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Introduction: Polyneuropathy (PNP) is a chronic progressive disease that over time can lead to damage of sensory, motor and/or autonomic peripheral nerves. Symptoms vary from predominantly sensory to severe sensorimotor affection both proximally and distally. This can result in considerable functional impairments that affect activities of daily living. In other neurological patients, strength training has shown to improve strength and functional outcomes. Since medical treatment only exists for very few percentages of the underlying causes it is obvious to consider if strength training could be a potential treatment for functional impairments. To date little is known on the effect of strength training in patients with PNP.Aim: The aim of this scoping review was to summarize research on strength training and outcomes on physical function in patients with PNP.Methods: We systematically searched five data bases; Pubmed, Embase, Cinahl, Cochrane library and Web of science. Studies on strength training (load ≥70% of 1RM) in patients with PNP were included. The search was carried out in November 2022.Results: 362 articles were screened by title and abstract, 101 articles were full text screened. Eight studies were included. Patients with Charcot-Marie-Tooth (CMT), chronic inflammatory polyneuropathy (CIDP) and diabetic polyneuropathy (DPN) were represented in the studies (five RCTs, two case-series, and one cross-over trial). The methodological quality ranged from fair-poor in seven studies, one study reached good quality. Results from the studies indicated that strength training in CMT, CIDP and DPN may improve strength. However, various outcomes were used to evaluate strength training, so direct comparisons were difficult.Discussion: In this scoping review we summarized research on strength training and outcomes evaluated in interventions in patients with PNP. Eight studies were included, they indicated that strength training may be beneficial for patients with PNP. However, due to low methodological strength of most studies a recommendation for patients with PNP cannot be made. Thus, the low number of studies with relatively low quality, where various functional outcomes were used, underscores the importance of future studies to evaluate the effect of strength training on relevant functional outcomes and strength in patients with PNP.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Effect of strength training on functional outcomes and strength in patients with polyneuropathy: A scoping review

et al. 2023

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“…The characteristics of each HIIT and strength training session that participants will perform have been designed according to the recommendations provided by guidelines31 and results reported in recent meta-analyses published by Andreu-Caravaca et al 15 16 and Campbell et al ,14 to optimise the long-term results of physical exercise programmes.…”

Section: Methodsmentioning

confidence: 99%

“…In this context, HIIT and strength training emerge as promising exercise strategies. However, achieving substantial benefits requires a minimum number of exercise sessions, underscoring the importance of adherence to the exercise programme when demonstrating positive effects 15 16. While the exact dropout and adherence rates in exercise programmes for MS remain unclear, several factors, such as age, gender distribution, disability level, exercise modality (HIIT vs strength training), intervention duration and specific exercises included, could potentially influence the dropout rate in physical exercise programmes 17.…”

Section: Introductionmentioning

confidence: 99%

Response to physical activity of females with multiple sclerosis throughout the menstrual cycle: a protocol for a randomised crossover trial (EMMA Project)

Rubio-Arias,

Ramos-Campo,

Romero-Parra

et al. 2023

BMJ Open Sport Exerc Med

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The relationship between multiple sclerosis (MS) and females is a crucial aspect in the development of the disease, with the ovarian hormonal cycle being a sensitive stage, especially in females with relapsing-remitting multiple sclerosis. The objectives of the study are to identify moderating variables that modify satisfaction with physical activity practice throughout the menstrual cycle (MC) in females in or out of their MC, during high-intensity interval training (HIIT) and strength training sessions and to compare the acute effects of different types of physical activity sessions in females with and without MS. This protocol is the methodology used in the EMMA Study, a randomised, single-blind crossover trial study conducted in females with MS who were matched 1:1, based on age, lifestyle factors and country of residence, with females without MS, to analyse the effect of physical activity practice on satisfaction, functionality, fatigue and inflammatory profile through their MC. Participants will visit the facilities approximately 10 times (4 preliminary familiarisation visits and 6 visits to carry out a physical activity session in each phase of the MC) for 3–4 months. A total sample of 30 females (15 females without MS and 15 with MS) is necessary for the study. The evaluation will comprise clinical, nutritional and psychological interviews, including different variables. It is hypothesised during the luteal phase, females with MS are expected to exhibit different acute responses to HIIT and strength training sessions as compared with females without the disease. Before starting the study, all participants will read and sign an informed consent form. Trial registration number: This research protocol is registered with ClinicalTrials.gov to ensure transparency and accessibility of study information (NCT06105463). The university’s ethics committee number for this study is UALBIO2022/048.

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“…M ultiple sclerosis (MS) is a highly variable condition that can cause a variety of impairments, which negatively impact functional activities and result in participation restrictions. [1][2][3] Rehabilitation interventions can improve impairments, activities, and participation for people with MS, 4,5 and there are reliable and valid, standardized outcome measures that can assess response to intervention using performance-based and/or patient-reported outcomes. 6,7 However, a limitation of many of these outcome measures is that they are not specific enough to always capture changes that are important to individual patients.…”

Section: Introductionmentioning

confidence: 99%

Reliability, Validity, and Responsiveness of the Patient-Specific Functional Scale for Measuring Mobility-Related Goals in People With Multiple Sclerosis

Mañago

Cohen

Cameron

et al. 2023

Journal of Neurologic Physical Therapy

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Background and Purpose: This study's purpose was to investigate the reliability, validity, and responsiveness of the Patient-Specific Functional Scale (PSFS) for measuring mobility-related goals in people with multiple sclerosis (MS). Methods: Data from 32 participants with MS who underwent 8 to 10 weeks of rehabilitation were analyzed (Expanded Disability Status Scale scores 1.0-7.0). For the PSFS, participants identified 3 mobility-related areas where they had difficulty and rated them at baseline, 10 to 14 days later (before starting intervention), and immediately after intervention. Test-retest reliability and response stability of the PSFS were calculated using the intraclass correlation coefficient (ICC2,1) and minimal detectable change (MDC95), respectively. Concurrent validity of the PSFS was determined with the 12-item Multiple Sclerosis Walking Scale (MSWS-12) and the Timed 25-Foot Walk Test (T25FW). PSFS responsiveness was determined using Cohen's d, and minimal clinically important difference (MCID) was calculated based on patient-reported improvements on a Global Rating of Change (GRoC) scale. Results: The PSFS total score demonstrated moderate reliability (ICC2,1 = 0.70, 95% CI: 0.46 to 0.84) and the MDC was 2.1 points. At baseline, the PSFS was fairly and significantly correlated with the MSWS-12 (r = −0.46, P = 0.008) but not with the T25FW. Changes in the PSFS were moderately and significantly correlated with the GRoC scale (ρ = 0.63, P < 0.001), but not with MSWS-12 or T25FW changes. The PSFS was responsive (d = 1.7), and the MCID was 2.5 points or more to identify patient-perceived improvements based on the GRoC scale (sensitivity = 0.85, specificity = 0.76). Discussion and Conclusions: This study supports the use of the PSFS as an outcome measure in people with MS to assess mobility-related goals. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A423).

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Effects and optimal dosage of resistance training on strength, functional capacity, balance, general health perception, and fatigue in people with multiple sclerosis: a systematic review and meta-analysis

Cited by 15 publications

References 91 publications

Effect of strength training on functional outcomes and strength in patients with polyneuropathy: A scoping review

Effect of strength training on functional outcomes and strength in patients with polyneuropathy: A scoping review

Response to physical activity of females with multiple sclerosis throughout the menstrual cycle: a protocol for a randomised crossover trial (EMMA Project)

Reliability, Validity, and Responsiveness of the Patient-Specific Functional Scale for Measuring Mobility-Related Goals in People With Multiple Sclerosis

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