“Resistance training for muscle weakness in multiple sclerosis: direct versus contralateral approach in individuals with ankle dorsiflexors’ disparity in strength.”

Publication date: Available online 23 March 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Andrea Manca, Maria Paola Cabboi, Daniele Dragone, Francesca Ginatempo, Enzo Ortu, Edoardo Rosario De Natale, Beniamina Mercante, Giovanni Mureddu, Guido Bua, Franca Deriu
ObjectiveTo compare effects of contralateral strength training (CST) versus direct strength training (DST) of the more-affected ankle dorsiflexors on muscle performance and clinical-functional outcomes in people with multiple sclerosis (MS) exhibiting inter-limb strength asymmetry.DesignRandomized controlled trialParticipantsIndividuals with relapsing-remitting MS and mild-to-moderate disability (EDSS≤6) presenting with ankle dorsiflexors' strength disparity.InterventionParticipants were randomly assigned to a CST (n=15) or DST (n=15) group performing a 6-week maximal-intensity strength training of the less- or more-affected dorsiflexors, respectively.Main Outcome MeasuresMaximal strength, endurance to fatigue and mobility outcomes were assessed before (PRE), at the intervention end (POST) and at 12-week follow-up. Strength and fatigue parameters were measured after 3 weeks of training (mid-intervention).ResultsIn the more-affected limb of both groups, PRE-to-POST significant increases in maximal strength (p≤0.006) and fatigue endurance (p≤0.04) were detected along with consistent retention of these improvements at follow-up (p≤0.04). At mid-intervention the DST group showed significant improvements (p≤0.002), with no further increase at the POST, despite training continuation. Conversely, the CST group showed non-significant strength gains, increasing to significance at the POST (p≤0.003). In both groups, significant PRE-to-POST improvements in mobility outcomes (p≤0.03), not retained at follow-up, were observed.ConclusionsAfter 6 weeks of training, CST proved as effective as DST in enhancing performance of the more-affected limb with a different time-course, which may have practical implications in management of severely weakened limbs where DST is not initially possible.



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