Advertisement

Effects of Classic Progressive Resistance Training Versus Eccentric-Enhanced Resistance Training in People With Multiple Sclerosis

Published:November 27, 2017DOI:https://doi.org/10.1016/j.apmr.2017.10.021

      Abstract

      Objective

      To compare the effects of classic progressive resistance training (PRT) versus eccentric strength-enhanced training (EST) on the performance of functional tests and different strength manifestations in the lower limb of people with multiple sclerosis (PwMS).

      Design

      Experimental trial.

      Setting

      Strength training program.

      Participants

      PwMS (N=52; 19 men, 33 women) belonging to MS associations from the Castilla y León, Spain.

      Interventions

      Participants were assigned to 1 of 2 groups: a control group that performed PRT or an experimental group that performed EST. In both groups, the knee extensor muscles were trained for 12 weeks.

      Main Outcome Measures

      Before and after 12 weeks of training, maximal voluntary isometric contraction and 1 repetition maximum (1RM) of the knee extensors were evaluated, as were the Chair Stand Test (CST) and Timed 8-Foot Up and Go (TUG) functional tests.

      Results

      No differences were found between the groups in the initial values for different tests. Intragroup comparisons found significant differences in CST (F=69.4; P<.001), TUG (F=40.0; P<.001), and 1RM (F=57.8; P<.001). For intergroup comparisons, EST presented better results than PRT in the CST (EST, 4.7%±2.8%; PRT, 1.9%±2.8%; F=13.1; P=.001) and TUG (EST, −2.9±4.7; PRT, −.41±5.6; F=5.6; P=.022).

      Conclusions

      In PwMS, EST leads to improvements in 1RM, TUG, and CST that are similar to those of PRT. However, for patients who participated in this study, the EST seems to promote a better transfer of strength adaptations to the functional tests, which are closer to daily-living activities.

      Keywords

      List of abbreviations:

      CST (Chair Stand Test), EST (eccentric strength-enhanced training), MS (multiple sclerosis), MVIC (maximal voluntary isometric contraction), 1RM (1 repetition maximum), PRT (progressive resistance training), PwMS (patients with multiple sclerosis), TUG (Timed 8-Foot Up and Go)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Denninson L.
        • Moss-Morris R.
        • Chalder T.
        A review of psychological correlates of adjustment in patients with multiple sclerosis.
        Clin Psychol Rev. 2009; 29: 141-153
        • Bove R.
        • Chitnis T.
        Sexual disparities in the incidence and course of MS.
        Clin Immunol. 2013; 149: 201-210
        • White L.J.
        • McCoy S.C.
        • Castellano V.
        • et al.
        Resistance training improves strength and functional capacity in persons with multiple sclerosis.
        Mult Scler. 2004; 10: 668-674
        • Flachenecker P.
        Clinical Implications of neuroplasticity—the role of rehabilitation in multiple sclerosis.
        Front Neurol. 2015; 6: 36
        • Pilutti L.
        • Greenlee T.
        • Motl R.
        • Nickrent N.
        • Petrezzello S.
        Effects of exercise training on fatigue in MS: a meta-analysis.
        Psychosom Med. 2013; 75: 575-580
        • Giesser B.
        • Beres-Jones J.
        • Budovitch A.
        • Herlihy E.
        • Harkema S.
        Locomotor training using body weight support on a treadmill improves mobility in persons with MS.
        Mult Scler. 2007; 13: 224-231
        • Sosnoff J.
        • Motl R.W.
        • Snook E.M.
        • Wynn D.
        Effect of a 4-week period of unloaded leg cycling exercise on spasticity in multiple sclerosis.
        NeuroRehabilitation. 2009; 24: 327-331
        • Tarakci E.
        • Yeldan I.
        • Huseyinsnoglu B.
        • Zenginier Y.
        • Eraksoy M.
        Group exercise training for balance, functional status, fatigue and quality of life in MS: a randomized controlled trial.
        Clin Rehabil. 2013; 27: 813-822
        • Kjølhede T.
        • Vissing K.
        • Dalgas U.
        MS and progressive resistance training: a systematic review.
        Mult Scler. 2012; 18: 1215-1228
        • Giesser B.S.
        Exercise in the management of persons with multiple sclerosis.
        Ther Adv Neurol Disord. 2015; 8: 123-130
        • Rice C.L.
        • Vollmer T.L.
        • Bigland-Ritchie B.
        Neuromuscular responses of patients with sclerosis multiple.
        Muscle Nerve. 1992; 15: 1123-1132
        • Sharma K.R.
        • Kent-Braun J.
        • Mynhier M.W.
        • Miller R.G.
        Evidence of an abnormal intramuscular component of fatigue in multiple sclerosis.
        Muscle Nerve. 1995; 18: 1403-1411
        • Haan A.
        • De Ruiter C.J.
        • Van Der Woud L.H.
        • Jongen P.J.
        Contractile properties and fatigue of quadriceps muscles in multiple sclerosis.
        Muscle Nerve. 2000; 23: 1534-1541
        • Thoumie P.
        • L'Amotte D.
        • Cantaloube S.
        • Foucher M.
        • Amarenco G.
        Motor determinants of gait in 100 ambulatory patients with MS.
        Mult Scler. 2005; 11: 485-491
        • Güner S.
        • Hagharı S.
        • Inanıcı F.
        • Alsancak S.
        • Aytekın G.
        Knee muscle strength in multiple sclerosis: relationship with gait characteristics.
        J Phys Ther Sci. 2015; 27: 809-813
        • Lindstedt S.L.
        • LaStayo P.C.
        • Reich T.E.
        When active muscles lengthen: properties and consequences of eccentric contractions.
        News Physiol Sci. 2001; 16: 256-261
        • Aagard P.
        • Simonsen E.B.
        • Andersen J.L.
        • Magnusson S.P.
        • Halkjaer-Kristensen J.
        • Dyhre-Poulsen P.
        Neural inhibition during maximal eccentric and concentric quadriceps contraction: effects of resistance training.
        J Appl Physiol (1985). 2000; 89: 2249-2257
        • Jiménez-Jiménez R.
        • Cuevas M.J.
        • Almar M.
        • et al.
        Eccentric training impairs NF-kappaB activation and over-expression of inflammation-related genes induced by acute eccentric exercise in the elderly.
        Mech Ageing Dev. 2008; 129: 313-321
        • Roig M.
        • Shadgan B.
        • Reid W.D.
        Eccentric exercise in patients with chronic health conditions: a systematic review.
        Physiother Can. 2008; 60: 146-160
        • Hortobágyi T.
        • Devita P.
        • Money J.
        • Barrier J.
        Effects of standard and eccentric overload strength training in young women.
        Med Sci Sports Exerc. 2001; 33: 1206-1212
        • Vikne H.
        • Refsnes P.E.
        • Ekmark M.
        • Medbø J.I.
        • Gundersen V.
        • Gundersen K.
        Muscular performance after concentric and eccentric exercise in trained men.
        Med Sci Sports Exerc. 2006; 38: 1770-1781
        • Fang Y.
        • Siemionow V.
        • Sahgal V.
        • Xiong F.
        • Yue G.H.
        Greater movement related cortical potential during human eccentric versus concentric muscle contractions.
        J Neurophysiol. 2001; 86: 1764-1772
        • Fernandez-Gonzalo R.
        • Nissemark C.
        • Åslund B.
        • Tesch P.A.
        • Sojka P.
        Chronic stroke patients show early and robust improvements in muscle and functional performance in response to eccentric-overload flywheel resistance training: a pilot study.
        J Neuroeng Rehabil. 2014; 11: 150
        • Casillas J.M.
        • Besson D.
        • Hannequin A.
        • et al.
        Effects of an eccentric training personalized by a low rate of perceived exertion on the maximal capacities in chronic heart failure.
        Eur J Phys Rehabil Med. 2016; 52: 159-168
        • McDonald W.I.
        • Compston A.
        • Edan G.
        • et al.
        Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the Diagnosis of Multiple Sclerosis.
        Ann Neurol. 2001; 50: 121-127
        • Kurtzke J.F.
        Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS).
        Neurology. 1983; 33: 1444-1452
        • Rikli R.E.
        • Jones C.J.
        Senior fitness test manual.
        Human Kinectics, Champaign2001
        • Medina-Perez C.
        • de Souza-Teixeira F.
        • Fernandez-Gonzalo R.
        • Hernandez-Murua J.
        • de Paz-Fernandez J.A.
        Effects of high-speed power training on muscle strength and power in patients with multiple sclerosis.
        J Rehabil Res Dev. 2016; 53: 359-368
        • Medina-Perez C.
        • de Souza-Teixeira F.
        • Fernandez-Gonzalo R.
        • de Paz-Fernandez J.A.
        Effects of a resistance training program and subsequent detraining on muscle strength and muscle power in multiple sclerosis patients.
        NeuroRehabilitation. 2014; 34: 523-530
        • De Souza-Teixeira F.
        • Costilla S.
        • Ayán C.
        • García-López D.
        • González-Gallego J.
        • de Paz J.A.
        Effects of resistance training in multiple sclerosis.
        Int J Sports Med. 2009; 30: 245-250
        • Kraemer W.J.
        • Ratamess N.A.
        • French D.N.
        Resistance training for health and performance.
        Curr Sports Med Rep. 2002; 1: 165-171
        • Gearhart Jr., R.F.
        • Lagally K.M.
        • Riechman S.E.
        • Andrews R.D.
        • Robertson R.J.
        Safety of using the adult Omni resistance exercise scale to determine 1-RM in older men and women.
        Percept Mot Skills. 2011; 113: 671-676
        • American College of Sports Medicine
        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
        • Tesch P.A.
        • Berg H.E.
        • Bring D.
        • Evans H.J.
        • Leblanc A.D.
        Effects of 17-day spaceflight on knee extensor muscle function and size.
        Eur J Appl Physiol. 2005; 93: 463-468
        • Dalgas U.
        • Stenager E.
        • Jakobsen J.
        • et al.
        Resistance training improves muscle strength and functional capacity in multiple sclerosis.
        Neurology. 2009; 73: 1478-1484
        • Douglas J.
        • Pearson S.
        • Ross A.
        • McGuigan M.
        Chronic adaptations to eccentric training: a systematic review.
        Sports Med. 2017; 47: 917-941
        • Tesch P.A.
        • Fernandez-Gonzalo R.
        • Lundberg T.R.
        Clinical applications of iso-inertial, eccentric-overload (YoYo™) resistance exercise.
        Front Physiol. 2017; 8: 241
        • Maroto-Izquierdo S.
        • García-López D.
        • Fernandez-Gonzalo R.
        • Moreira O.C.
        • González-Gallego J.
        • de Paz J.A.
        Skeletal muscle functional and structural adaptations after eccentric overload flywheel resistance training: a systematic review and meta-analysis.
        J Sci Med Sport. 2017; 20: 943-951
        • Samaei A.
        • Bakhtiary A.H.
        • Hajihasani A.
        • Fatemi E.
        • Motaharinezhad F.
        Uphill and downhill walking in multiple sclerosis: a randomized controlled trial.
        Int J MS Care. 2016; 18: 34-41
        • Manca A.
        • Cabboi M.P.
        • Dragone D.
        • et al.
        Resistance training for muscle weakness in multiple sclerosis: direct versus contralateral approach in individuals with ankle dorsiflexors' disparity in strength.
        Arch Phys Med Rehabil. 2017; 98: 1348-1356
        • Sebastião E.
        • Sandroff B.M.
        • Learmonth Y.C.
        • Motl R.W.
        Validity of the Timed Up and Go test as a measure of functional mobility in persons with multiple sclerosis.
        Arch Phys Med Rehabil. 2016; 97: 1072-1077
        • Eckardt N.
        Lower-extremity resistance training on unstable surfaces improves proxies of muscle strength, power and balance in healthy older adults: a randomised control trial.
        BMC Geriatr. 2016; 16: 191
        • Nie H.
        • Arendt-Nielsen L.
        • Kawczynski A.
        • Madeleine P.
        Gender effects on trapezius surface EMG during delayed onset muscle soreness due to eccentric shoulder exercise.
        J Electromyogr Kinesiol. 2007; 17: 401-409
        • Kenney W.L.
        • Wilmore J.
        • Costill D.
        Physiology of sport and exercise.
        6th ed. Human Kinetcs, Champaign2015
        • Pearson M.
        • Dieberg G.
        • Smart N.
        Exercise as a therapy for improvement of walking ability in adults with multiple sclerosis: a meta-analysis.
        Arch Phys Med Rehabil. 2015; 96: 1339-1348
        • Motl R.W.
        • Balantrapu S.
        • Pilutti L.
        • Dlugonski D.
        • Suh Y.
        • Sandroff B.M.
        Symptomatic correlates of six-minute walk performance in persons with multiple sclerosis.
        Eur J Phys Rehabil Med. 2013; 49: 59-66
        • Robineau S.
        • Nicolas B.
        • Gallien P.
        • et al.
        Eccentric isokinetic strengthening in hamstrings of patients with multiple sclerosis.
        Ann Readapt Med Phys. 2005; 48: 29-33
        • Buch A.
        • Carmeli E.
        • Boker L.K.
        • et al.
        Muscle function and fat content in relation to sarcopenia, obesity and frailty of old age—an overview.
        Exp Gerontol. 2016; 76: 25-32
        • Brady A.O.
        • Straight C.R.
        • Evans E.M.
        Body composition, muscle capacity, and physical function in older adults: an integrated conceptual model.
        J Aging Phys Act. 2014; 22: 441-452