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Perception of Muscular Effort During Dynamic Elbow Extension in Multiple Sclerosis

Published:October 22, 2015DOI:https://doi.org/10.1016/j.apmr.2015.10.082

      Abstract

      Objective

      To investigate the perception of muscular effort in individuals with multiple sclerosis (MS) and healthy controls during dynamic contractions.

      Design

      Case-control study.

      Setting

      MS day care center.

      Participants

      Individuals with MS (n=28) and controls (n=28) (N=56).

      Interventions

      Not applicable.

      Main Outcome Measures

      Perceived muscular effort during dynamic elbow extensions was rated at 9 different weight intensities (10%–90% of 1-repetition maximum) in a single-blind, randomized order using the OMNI-Resistance Exercise Scale. Muscle activity of the triceps brachii muscle (lateral head) was measured via surface electromyography and normalized to maximal voluntary excitation.

      Results

      According to OMNI-level ratings, significant main effects were found for the diagnostic condition (F=27.33, P<.001, η2=.11), indicating 0.7 (95% confidence interval [CI], 0.3–1.1) lower mean OMNI-level ratings for MS, and for the intensity level (F=46.81, P<.001, η2=.46), showing increased OMNI-level ratings for increased intensity levels for both groups. Furthermore, significant main effects were found for the diagnostic condition (F=16.52, P<.001, η2=.07), indicating 7.1% (95% CI, −8.6 to 22.8) higher maximal voluntary excitation values for MS, and for the intensity level (F=33.09, P<.001, η2=.36), showing higher relative muscle activities for increasing intensity levels in both groups.

      Conclusions

      Similar to controls, individuals with MS were able to differentiate between different intensities of weight during dynamic elbow extensions when provided in a single-blind, randomized order. Therefore, perceived muscular effort might be considered to control resistance training intensities in individuals with MS. However, training intensity for individuals with MS should be chosen at approximately 1 OMNI level lower than recommended, at least for dynamic elbow extension exercises.

      Keywords

      List of abbreviations:

      CI (confidence interval), ICC (intraclass correlation coefficient), MS (multiple sclerosis), OMNI-RES (OMNI-Resistance Exercise Scale), 1RM (1-repetition maximum)
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      References

        • Kjølhede T.
        • Vissing K.
        • Dalgas U.
        Multiple sclerosis and progressive resistance training: a systematic review.
        Mult Scler. 2012; 18: 1215-1228
        • Latimer-Cheung A.E.
        • Pilutti L.A.
        • Hicks A.L.
        • et al.
        Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development.
        Arch Phys Med Rehabil. 2013; 94: 1800-1828
        • McArdle W.D.
        • Katch F.I.
        • Katch V.L.
        Essentials of exercise physiology.
        2nd ed. Lippincott Williams & Wilkins, Philadelphia2000
        • Braith R.W.
        • Graves J.E.
        • Leggett S.H.
        • Pollock M.L.
        Effect of training on the relationship between maximal and submaximal strength.
        Med Sci Sports Exerc. 1993; 25: 132-138
        • Garber C.E.
        • Blissmer B.
        • Deschenes M.R.
        • et al.
        American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise.
        Med Sci Sports Exerc. 2011; 43: 1334-1359
        • Tiggemann C.L.
        • Korzenowski A.L.
        • Brentano M.A.
        • Tartaruga M.P.
        • Alberton C.L.
        • Kruel L.F.
        Perceived exertion in different strength exercise loads in sedentary, active, and trained adults.
        J Strength Cond Res. 2010; 24: 2032-2041
        • Naclerio F.
        • Rodríguez-Romo G.
        • Barriopedro-Moro M.I.
        • Jiménez A.
        • Alvar B.A.
        • Triplett N.T.
        Control of resistance training intensity by the OMNI perceived exertion scale.
        J Strength Cond Res. 2011; 25: 1879-1888
        • Latimer-Cheung A.E.
        • Martin Ginis K.A.
        • Hicks A.L.
        • et al.
        Development of evidence-informed physical activity guidelines for adults with multiple sclerosis.
        Arch Phys Med Rehabil. 2013; 94: 1829-1836
        • Kiselka A.
        • Greisberger A.
        • Heller M.
        Perception of muscular effort in multiple sclerosis.
        NeuroRehabilitation. 2013; 32: 415-423
        • Noakes T.D.
        Time to move beyond a brainless exercise physiology: the evidence for complex regulation of human exercise performance.
        Appl Physiol Nutr Metab. 2011; 36: 23-25
        • Tucker R.
        The anticipatory regulation of performance: the physiological basis for pacing strategies and the development of a perception-based model for exercise performance.
        Br J Sports Med. 2009; 43: 392-400
        • Dalgas U.
        • Stenager E.
        • Ingemann-Hansen T.
        Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training.
        Mult Scler. 2008; 14: 35-53
        • Polman C.H.
        • Reingold S.C.
        • Banwell B.
        • et al.
        Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.
        Ann Neurol. 2011; 69: 292-302
        • Kurtzke J.F.
        Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).
        Neurology. 1983; 33: 1444-1452
        • Folstein M.F.
        • Folstein S.E.
        • McHugh P.R.
        “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician.
        J Psychiat Res. 1975; 12: 189-198
        • Beck A.T.
        • Ward C.H.
        • Mendelson M.
        • Mock J.
        • Erbaugh J.
        An inventory for measuring depression.
        Arch Gen Psychiatry. 1961; 4: 561-571
        • Robertson R.J.
        • Goss F.L.
        • Rutkowski J.
        • et al.
        Concurrent validation of the OMNI perceived exertion scale for resistance exercise.
        Med Sci Sports Exerc. 2003; 35: 333-341
        • Elbers R.G.
        • Rietberg M.B.
        • van Wegen E.E.
        • et al.
        Self-report fatigue questionnaires in multiple sclerosis, Parkinson's disease and stroke: a systematic review of measurement properties.
        Qual Life Res. 2012; 21: 925-944
        • Hermens H.J.
        • Freriks B.
        • Disselhorst-Klug C.
        • Rau G.
        Development of recommendations for SEMG sensors and sensor placement procedures.
        J Electromyogr Kines. 2000; 10: 361-374
        • Staudenmann D.
        • Roeleveld K.
        • Stegeman D.F.
        • van Dieën J.H.
        Methodological aspects of SEMG recordings for force estimation–a tutorial and review.
        J Electromyogr Kines. 2010; 20: 375-387
        • Lagally K.M.
        • Robertson R.J.
        Construct validity of the OMNI resistance exercise scale.
        J Strength Cond Res. 2006; 20: 252-256
        • Kluger B.M.
        • Krupp L.B.
        • Enoka R.M.
        Fatigue and fatigability in neurologic illnesses: proposal for a unified taxonomy.
        Neurology. 2013; 80: 409-416
        • Pilutti L.A.
        • Greenlee T.A.
        • Motl R.W.
        • Nickrent M.S.
        • Petruzzello S.J.
        Effects of exercise training on fatigue in multiple sclerosis: a meta-analysis.
        Psychosom Med. 2013; 75: 575-580
        • Thickbroom G.W.
        • Sacco P.
        • Kermode A.G.
        • et al.
        Central motor drive and perception of effort during fatigue in multiple sclerosis.
        J Neurol. 2006; 253: 1048-1053
        • American College of Sports Medicine
        American College of Sports Medicine position stand. Progression models in resistance training for healthy adults.
        Med Sci Sports Exerc. 2009; 41: 687-708
        • Bigland-Ritchie B.
        EMG/force relations and fatigue of human voluntary contractions.
        Exercise Sport Sci Rev. 1981; 9: 75-117
        • Ng A.V.
        • Miller R.G.
        • Kent-Braun J.A.
        Central motor drive is increased during voluntary muscle contractions in multiple sclerosis.
        Muscle Nerve. 1997; 20: 1213-1218
        • Ng A.V.
        • Miller R.G.
        • Gelinas D.
        • Kent-Braun J.A.
        Functional relationships of central and peripheral muscle alterations in multiple sclerosis.
        Muscle Nerve. 2004; 29: 843-852
        • de Haan A.
        • de Ruiter C.J.
        • van der Woude L.H.
        • Jongen P.J.
        Contractile properties and fatigue of quadriceps muscles in multiple sclerosis.
        Muscle Nerve. 2000; 23: 1534-1541
        • Rice C.L.
        • Vollmer T.L.
        • Bigland-Ritchie B.
        Neuromuscular responses of patients with multiple sclerosis.
        Muscle Nerve. 1992; 15: 1123-1132
        • DeLuca J.
        • Nocentini U.
        Neuropsychological, medical and rehabilitative management of persons with multiple sclerosis.
        NeuroRehabilitation. 2011; 29: 197-219
        • Gibson A.S.
        • Noakes T.D.
        Evidence for complex system integration and dynamic neural regulation of skeletal muscle recruitment during exercise in humans.
        Br J Sports Med. 2004; 38: 797-806
        • Lamers I.
        • Kerkhofs L.
        • Raats J.
        • Kos D.
        • Van Wijmeersch B.
        • Feys P.
        Perceived and actual arm performance in multiple sclerosis: relationship with clinical tests according to hand dominance.
        Mult Scler. 2013; 19: 1341-1348