Effects of a Community-Based Progressive Resistance Training Program on Muscle Performance and Physical Function in Adults With Down Syndrome: A Randomized Controlled Trial
Shields and colleagues assess the effects of progressive resistance training on the muscle strength, endurance, and physical function in 20 adults with Down syndrome. Subjects were randomized into 2 groups. One group underwent a supervised weight machine training program twice weekly for 10 weeks; the program involved equal numbers of upper- and lower-extremity exercises. The other group (control) continued with its usual activities. Assessment at the end of the training period revealed a statistically significant 17% improvement in upper-limb muscle endurance and trends toward improvements in upper-limb strength and function in the intervention group but no significant improvement in any of the lower-limb measures. There were no significant adverse events. The authors conclude that progressive resistance training is a safe and feasible way to improve upper-limb muscle endurance in adults with Down syndrome. • SEE PAGE 1215
Beth E. Fisher, PhD
Allan D. Wu, MD
George J. Salem, PhD
Jooeun E. Song, MS
Chien-Ho (Janice) Lin, PhD
Jeanine Yip, DPT
Steven Cen, PhD
James Gordon, EdD
Michael Jakowec, PhD
Giselle Petzinger, MD
The Effect of Exercise Training in Improving Motor Performance and Corticomotor Excitability in Persons With Early Parkinson's Disease
Movement and exercise appear important in promoting neurogenesis and recovery following brain injury. Fisher and colleagues report on 1 aspect of this issue in a preliminary study involving 30 subjects with Parkinson's disease of recent onset. Subjects were divided into 3 groups: 10 underwent a high-intensity, 24-session, 8-week weight-supported treadmill training regimen; 10 had a similar but lower-intensity program; and 10 attended a series of educational meetings. Unified Parkinson's Disease Rating Scale (UPDRS) scores, biomechanic gait measurements, sit-to-stand function, and cortical excitability (as defined by single-pulse transcortical magnetic stimulation) were assessed at the beginning and end of the trial. All groups showed small improvements in their UPDRS scores, with the high-intensity group tending to show a somewhat better performance than the others in its postexercise gait parameters, hip and ankle joint excursions, and sit-to-stand activities. Perhaps, most significantly, the high-intensity group demonstrated a lessening of cortical excitability that the authors suggest supports the idea that high-intensity exercise may be able to normalize cortical excitability in early Parkinson's disease. • SEE PAGE 1221
Walter Bily, MD
Lukas Trimmel, MD
Michaela Mödlin, MD
Alexandra Kaider, MSc
Helmut Kern, MD
Training Program and Additional Electric Muscle Stimulation for Patellofemoral Pain Syndrome: A Pilot Study
Patellofemoral pain is a common cause of anterior knee pain that is typically treated with an exercise program directed toward quadriceps strengthening. Bily and colleagues conducted a randomized control trial of 38 subjects to assess the benefits of adding a home-based electric stimulation strengthening program to an intensive supervised training regimen. Half the subjects received physiotherapeutic supervised training for 12 weeks and the remainder received the same training but, in addition, took part in a home-based, twice daily, 5-day-a-week electric stimulation strengthening program. Outcome measures included visual analog scale pain determinations, the Kujala patellofemoral score, and isometric strength measurements before and after treatment as well as 1 year later. The groups did not differ in outcome; knee extensor strength was similar at the end of training, and both reported a statistically significant lessening of pain and improved function at that time as well as at follow-up. The investigators conclude that while a supervised training program can reduce pain and improve function in patients with patellofemoral pain syndrome, the addition of electric stimulation provided no additional advantage. • SEE PAGE 1230
Jacqui H. Morris, MSc
Frederike van Wijck, PhD
Sara Joice, PhD
Simon A. Ogston, PhD
Ingrid Cole, BSc
Ronald S. MacWalter, MD
A Comparison of Bilateral and Unilateral Upper-Limb Task Training in Early Poststroke Rehabilitation: A Randomized Controlled Trial
Stroke rehabilitation has typically focused on the involved limb. More recently, bilateral limb training, which has the theoretical advantages of using the movements of the nonparetic limb as a template to aid in training of its paretic counterpart, has gained some attention. Evidence, however, of the benefits of 1 approach over the other remains unclear. The authors compared the effects of bilateral and unilateral upper-limb task training in a randomized controlled trial involving 106 people with strokes of 2 to 4 weeks in duration. Fifty-six subjects received bilateral and 50 unilateral training in standardized 20-minute sessions on a 5-day-a week, 6-week program. Action Research Arm Test (ARAT), Rivermead Motor Assessment upper limb scale, and Nine Hole Peg Test (9HPT) scores as well as a number of secondary measures were collected at the completion of training and 12 weeks later. No significant differences were found between the groups at the end of training; at follow-up, the only differences between the groups were in the 9HPT and ARAT pinch section, in which the bilateral group appeared to do less well. Morris and colleagues conclude that, while more research is needed, bilateral training appears to provide no benefits over unilateral training alone. • SEE PAGE 1237
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