Strength Training to Improve Gait in People with Multiple Sclerosis

Abstract

Practice Points• In studies that implemented strength training and measured gait outcomes, this review found a trend for significant improvement in strength outcomes, however not for gait performance as measured by speed and endurance.• This review found that studies including strength training for people with MS, either alone or in combination with other rehabilitation interventions, are typically prescribed in a manner consistent with current guidelines, and can improve strength. However, in order to improve gait, future studies might consider exploring higher intensities or frequencies.• This review found that strength training exercises most often focused on the knee and were performed on weight machines in a sitting position. This may be a reason strength training has not resulted in consistent improvements in gait, and future studies are needed that investigate muscle targets, positions, and modes of exercise that are functionally relevant to gait. www.ijmsc.org International Journal of MS Care PreprintO n l i n e F i r s t 3 Abstract Background: There are mixed reports on the effectiveness of strength training to improve gait

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

“…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 ).…”

“…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 ).…”

The MoXFo Initiative: Using consensus methodology to move forward towards internationally shared vocabulary in multiple sclerosis exercise research

“…1 There is now strong evidence for the benefits of exercise in multiple sclerosis (MS). 2 For people living with MS, exercise has the potential to improve physical fitness, 3,4 walking mobility, [5][6][7] strength, 7,8 balance, 9 cognition, 10 fatigue, 4,[11][12][13] mood 14 and quality of life. 15,16 Evidence from interventions in pwMS further indicates that exercise improves outcomes measured by magnetic resonance imaging and modulates peripheral biomarkers associated with neural health.…”

The Role of Perceived Energy and Self-Beliefs for Physical Activity and Sports Activity of Patients With Multiple Sclerosis and Chronic Stroke

“…Excellent reviews and meta-analyses advocate the merits of exercise for well-being (e.g., reduced depressive symptoms, higher quality of life), and showed positive effects on cognitive functioning ( Mandolesi et al, 2018 ) for adults with neurologic disorders such as multiple sclerosis ( Pilutti et al, 2013 ; Adamson et al, 2015 ; Motl et al, 2017 ) and chronic stroke ( Chen and Rimmer, 2011 ; Eng and Reime, 2014 ). For example, MS patients gait abnormalities and impairment ( Comber et al, 2017 ; Liparoti et al, 2019 ) can be reduced by exercise (e.g., strength training, Mañago et al, 2019 ). Some authors even go so far to recommend “sports as medicine” ( Dalgas et al, 2019 ).…”