Resistance Training for Muscle Weakness in Multiple Sclerosis: Direct Versus Contralateral Approach in Individuals With Ankle Dorsiflexors' Disparity in Strength

Manca, Andrea; Cabboi, Maria Paola; Dragone, Daniele; Ginatempo, Francesca; Ortu, Enzo; Natale, Edoardo Rosario de; Mercante, Beniamina; Mureddu, Giovanni; Bua, Guido; Deriu, Franca

doi:10.1016/j.apmr.2017.02.019

Cited by 37 publications

(28 citation statements)

References 37 publications

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“…This study showed no strength improvement for either the trained or untrained limb for the ST group, whereas Dragert and Zehr (2013) reported a 34% and 31% PT strength increase in the trained and untrained limbs of stroke patients following 6 weeks (18 sessions) unilateral isometric dorsiflexion strengthening. Manca, Cabboi, et al (2017) Furthermore, participant's effort in our study was not objectively measured during training. It is possible that participants did not consistently reach a high enough intensity (80-100% MVC) needed to elicit significant PT strength transfer to the untrained limb (Fimland et al, 2009).…”

Section: Discussionmentioning

confidence: 98%

“…This study showed no strength improvement for either the trained or untrained limb for the ST group, whereas Dragert and Zehr () reported a 34% and 31% PT strength increase in the trained and untrained limbs of stroke patients following 6 weeks (18 sessions) unilateral isometric dorsiflexion strengthening. Manca, Cabboi, et al () recently demonstrated a linear response to unilateral strength training, requiring 6 weeks to achieve any significant cross‐education strength gains in the untrained dorsiflexors in neurologically impaired (multiple sclerosis) subjects. Our low magnitude of strength transfer for both groups may in part be due to intervention duration and training dose (4 weeks, 12 sessions), which compared with previous cross‐education studies (typically 4–6 weeks, >16 sessions; Dragert & Zehr, ; Manca, Cabboi, et al, ; Manca, Pisanu, Ortu, & Deriu, ) is a short intervention with minimal treatment dose.…”

Section: Discussionmentioning

confidence: 99%

“…Manca, Cabboi, et al () recently demonstrated a linear response to unilateral strength training, requiring 6 weeks to achieve any significant cross‐education strength gains in the untrained dorsiflexors in neurologically impaired (multiple sclerosis) subjects. Our low magnitude of strength transfer for both groups may in part be due to intervention duration and training dose (4 weeks, 12 sessions), which compared with previous cross‐education studies (typically 4–6 weeks, >16 sessions; Dragert & Zehr, ; Manca, Cabboi, et al, ; Manca, Pisanu, Ortu, & Deriu, ) is a short intervention with minimal treatment dose. Furthermore, participant's effort in our study was not objectively measured during training.…”

Section: Discussionmentioning

confidence: 99%

“…Though cross-education combined with mirror therapy was not previ- Isometric strengthening, a safe and easily implemented training mode (Harbo, Brincks, & Andersen, 2012), has previously shown to elicit significant strength transfer to the untrained limb following stroke (Dragert & Zehr, 2013). However, Manca, Cabboi, et al (2017) report that dynamic training modes achieve a greater mean strength transfer (16%) than isometric training (8%). Similarly, Zult et al (2016) conclude that a dynamic form of training that allows for a moving mirror image is more effective in generating a training effect.…”

Section: Discussionmentioning

confidence: 99%

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Unilateral dorsiflexor strengthening with mirror therapy to improve motor function after stroke: A pilot randomized study

Simpson

Ehrensberger

Horgan

et al. 2019

Physiotherapy Res Intl

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Background Independently, cross‐education, the performance improvement of the untrained limb following unilateral training, and mirror therapy have shown to improve lower limb functioning poststroke. Mirror therapy has shown to augment the cross‐education effect in healthy populations. However, this concept has not yet been explored in a clinical setting. Objectives This study set out to investigate the feasibility and potential efficacy of applying cross‐education combined with mirror therapy compared with cross‐education alone for lower limb recovery poststroke. Methods Thirty‐one chronic stroke participants (age 61.7 ± 13.3) completed either a unilateral strength training (ST; n = 15) or unilateral strength training with mirror‐therapy (MST; n = 16) intervention. Both groups isometrically strength trained the less‐affected ankle dorsiflexors three times per week for 4 weeks. Only the MST group observed the mirror reflection of the training limb. Patient eligibility, compliance, treatment reliability, and outcome measures were assessed for feasibility. Maximal voluntary contraction (MVC; peak torque, rate of torque development, and average torque), 10‐m walk test, timed up and go (TUG), Modified Ashworth Scale (MAS), and the London Handicap Scale (LHS) were assessed at pretraining and posttraining. Results Treatment and assessments were well tolerated without adverse effects. No between group differences were identified for improvement in MVC, MAS, TUG, or LHS. Only the combined treatment was associated with functional improvements with the MST group showing an increase in walking velocity. Conclusion Cross‐education plus mirror therapy may have potential for improving motor function after stroke. This study demonstrates the feasibility of the combination treatment and the need for future studies with larger sample sizes to investigate the effectiveness of the treatment.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Unilateral dorsiflexor strengthening with mirror therapy to improve motor function after stroke: A pilot randomized study

Simpson

Ehrensberger

Horgan

et al. 2019

Physiotherapy Res Intl

View full text Add to dashboard Cite

show abstract

“…These outcomes corroborate those of a previous study [39], which showed that a very short circuit training program with elastic bands designed for MS patients generates modest improvements in power, an increase in functional capacity and a reduction of their perception of fatigue. Additionally, 6 weeks of isokinetic strength training are sufficient to increase maximum strength and reduce the levels of fatigue in the ankle dorsiflexors of MS patients [40], which showed that a very short circuit training program with elastic bands designed for MS patients generates modest improvements in power, an increase in functional capacity and a reduction of their perception of fatigue. Similarly, the same training period performed three times per week by means of seated rowing, chest press, leg extension and leg press exercises significantly improved performance in the 10 m timed walk test, the 3 min step test and the timed up and go test, with no significant effects on balance [41].…”

Section: Discussionmentioning

confidence: 99%

Benefits of Static Stretching, Pliates® and Elastic Bands Resistance Training on Patients with Relapsing-Remitting Multiple Sclerosis: A Longitudinal Study

Ponzano¹,

Beratto²,

Mazza³

et al. 2017

J Neurol Neurophysiol

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Objective: To compare the effects of Pilates ® , a 30 s static stretching protocol and elastic bands resistance training on lower and hand-grip strength, rachis morphology, flexibility and body balance among RRMS patients.Methods: Twenty-two subjects affected by relapsing-remitting multiple sclerosis (RRMS, EDSS ≤ 6) were randomly divided into 3 groups whose members each performed 16 weeks of training. Stabilometry, rachis morphology, sit and reach, handgrip and sit to stand tests were performed three times: T0, after a month of learning training protocols; T1, after eight weeks of training; and T2, after sixteen weeks of training. Results Conclusion:Static stretching, Pilates and resistance training are useful to increase the autonomy in the daily life of people with MS thanks to the adoption of these three different training methods.

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Changes in walking speed following resistance training in people with multiple sclerosis: A systematic review and meta‐analysis

McManaman,

Novak,

Paul

et al. 2024

PM&R

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BackgroundReduced walking ability, especially decreased gait speed, is one of the most common and disabling impairments reported by people with multiple sclerosis (MS). Considering the impact of muscle strength on walking ability, resistance training may have the potential to improve walking speed in MS. Therefore, this systematic review and meta‐analysis aims to evaluate the effect of lower limb resistance training on walking speed in people with MS.MethodsSeven databases (CINAHL, MEDLINE, The Allied and Complimentary Medicine Database, Web of Science, Physiotherapy Evidence Database [PEDro], PsycINFO, and Sports Medicine and Education Index) were searched in March 2024 for studies that met the following eligibility criteria: randomized controlled trials investigating the effects of resistance training interventions on objective measures of walking speed in people with MS. Risk of bias was assessed using the PEDro scale. Meta‐analysis was performed to quantify intervention effect using a random effects model.ResultsTwelve randomized controlled trials were included, reporting data on 425 individuals with MS. Participants had mostly relapsing–remitting MS (85%) and a mild–moderate level of disability (Expanded Disability Status Score 1.0–6.0). Results of the meta‐analysis (based on 7 of the included studies) indicated a significant yet variable improvement in walking speed in favor of the intervention (0.10 m/s, 95% confidence interval 0.01–0.19, p < .05). Sensitivity analysis indicates that larger improvements in walking speed were found over tests covering shorter distances.ConclusionsResistance training was found to significantly improve walking speed in people with MS. However, variability in results were noted across studies; accordingly, future research should determine how variables—particularly related to resistance training prescription—influence the intervention effect.

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Resistance Training for Muscle Weakness in Multiple Sclerosis: Direct Versus Contralateral Approach in Individuals With Ankle Dorsiflexors' Disparity in Strength

Cited by 37 publications

References 37 publications

Unilateral dorsiflexor strengthening with mirror therapy to improve motor function after stroke: A pilot randomized study

Unilateral dorsiflexor strengthening with mirror therapy to improve motor function after stroke: A pilot randomized study

Benefits of Static Stretching, Pliates® and Elastic Bands Resistance Training on Patients with Relapsing-Remitting Multiple Sclerosis: A Longitudinal Study

Changes in walking speed following resistance training in people with multiple sclerosis: A systematic review and meta‐analysis

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