Six minutes of walking leads to reduced lower limb strength and increased postural sway in people with Multiple Sclerosis

2014 ◽  
Vol 35 (3) ◽  
pp. 503-508 ◽  
Author(s):  
J.V. McLoughlin ◽  
C.J. Barr ◽  
M. Crotty ◽  
D.L. Sturnieks ◽  
S.R. Lord
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Postural Sway ◽  
Lower Limb Strength

scholarly journals Effect of Functional Electrical Stimulation Cycling Exercise on Lower Limb Strength Asymmetry in Persons with Multiple Sclerosis

2021 ◽  
Author(s):  
John W. Farrell ◽  
Thomas Edwards ◽  
Robert W. Motl ◽  
Lara A. Pilutti
Keyword(s):  
Multiple Sclerosis ◽  
Electrical Stimulation ◽  
Lower Limb ◽  
Knee Extensor ◽  
Test Time ◽  
Mobility Impairment ◽  
Knee Flexor ◽  
Lower Limb Strength ◽  
Leg Cycling ◽  
Strength Asymmetry

Abstract Background: Lower limb strength asymmetry (ie, significant difference between contralateral limbs) has been associated with mobility impairment in persons with multiple sclerosis (MS). However, whether an adaptive exercise modality can be used to modify lower limb strength and potentially improve mobility is unclear. The effect of functional electrical stimulation (FES) cycling on lower limb strength asymmetry in persons with MS with mobility impairment was assessed, and the association between change in lower limb strength asymmetries and changes in functional and self-reported mobility outcomes was explored. Methods: Eight adults with MS (Expanded Disability Status Scale scores, 5.5–6.5) were included. Outcomes included knee extensor and knee flexor strength asymmetry, Timed 25-Foot Walk (T25FW) test, 2-Minute Walk Test (2MWT), Timed Up and Go (TUG) test, and 12-item Multiple Sclerosis Walking Scale (MSWS-12). Participants received 24 weeks (three times per week) of FES cycling or passive leg cycling. Results: The FES condition demonstrated a small decrease in knee extensor (d = −0.33) and knee flexor (d = −0.23) strength asymmetry compared with passive leg cycling. With both groups combined, moderate-to-strong associations were observed between change in knee extensor asymmetry and change in T25FW test time (rs = −0.43), 2MWT time (rs = −0.24), TUG test time (rs = 0.55), and MSWS-12 score (rs = 0.43). Moderate correlations were observed between change in knee flexor asymmetry and change in T25FW test time (rs = −0.31), TUG test time (rs = 0.33), and MSWS-12 score (rs = 0.35). Conclusions: FES cycling may be an efficacious exercise modality for reducing lower limb strength asymmetry and improving mobility in persons with MS.

scholarly journals Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 598
Author(s):  
Massimiliano Pau ◽  
Bruno Leban ◽  
Michela Deidda ◽  
Federica Putzolu ◽  
Micaela Porta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Cross Sectional Study ◽  
Camera Motion ◽  
Cross Sectional ◽  
Temporal Parameters ◽  
Wide Range ◽  
Edss Score ◽  
Spatio Temporal

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

scholarly journals COVID-19 era in long-term cardiac rehabilitation programs: how was muscle strenght and lean mass affected in cardiovascular patients?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Borges ◽  
M Lemos Pires ◽  
R Pinto ◽  
G De Sa ◽  
I Ricardo ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Cardiac Rehabilitation ◽  
Lean Mass ◽  
Lower Limb ◽  
Lower Limbs ◽  
Phase Iii ◽  
Face To Face ◽  
Home Based ◽  
Lower Limb Strength

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Exercise prescription is one of the main components of phase III Cardiac Rehabilitation (CR) programs due to its documented prognostic benefits. It has been well established that, when added to aerobic training, resistance training (RT) leads to greater improvements in peripheral muscle strength and muscle mass in patients with cardiovascular disease (CVD). With COVID-19, most centre-based CR programs had to be suspended and CR patients had to readjust their RT program to a home-based model where weight training was more difficult to perform. How COVID-19 Era impacted lean mass and muscle strength in trained CVD patients who were attending long-term CR programs has yet to be discussed. Purpose To assess upper and lower limb muscle strength and lean mass in CVD patients who had their centre-based CR program suspended due to COVID-19 and compare it with previous assessments. Methods 87 CVD patients (mean age 62.9 ± 9.1, 82.8% male), before COVID-19, were attending a phase III centre-based CR program 3x/week and were evaluated annually. After 7 months of suspension, 57.5% (n = 50) patients returned to the face-to-face CR program. Despite all constraints caused by COVID-19, body composition and muscle strength of 35 participants (mean age 64.7 ± 7.9, 88.6% male) were assessed. We compared this assessment with previous years and established three assessment time points: M1) one year before COVID-19 (2018); M2) last assessment before COVID-19 (2019); M3) the assessment 7 months after CR program suspension (last trimester of 2020). Upper limbs strength was measured using a JAMAR dynamometer, 30 second chair stand test (number of repetitions – reps) was used to measure lower limbs strength and dual energy x-ray absorptiometry was used to measure upper and lower limbs lean mass. Repeated measures ANOVA were used. Results Intention to treat analysis showed that upper and lower limbs lean mass did not change from M1 to M2 but decreased significantly from M2 to M3 (arms lean mass in M2: 5.68 ± 1.00kg vs M3: 5.52 ± 1.06kg, p = 0.004; legs lean mass in M2: 17.40 ± 2.46kg vs M3: 16.77 ± 2.61kg, p = 0.040). Lower limb strength also decreased significantly from M2 to M3 (M2: 23.31 ± 5.76 reps vs M3: 21.11 ± 5.31 reps, p = 0.014) after remaining stable in the year prior to COVID-19. Upper limb strength improved significantly from M1 to M2 (M1: 39.00 ± 8.64kg vs M2: 40.53 ± 8.77kg, p = 0.034) but did not change significantly from M2 to M3 (M2 vs M3: 41.29 ± 9.13kg, p = 0.517). Conclusion After CR centre-based suspension due to COVID-19, we observed a decrease in upper and lower limbs lean mass and lower limb strength in previously trained CVD patients. These results should emphasize the need to promote all efforts to maintain physical activity and RT through alternative effective home-based CR programs when face-to-face models are not available or possible to be implemented.

Non-invasive brain stimulation to assess neurophysiologic underpinnings of lower limb motor impairment in multiple sclerosis

2021 ◽  
Vol 356 ◽  
pp. 109143
Author(s):  
Clayton W. Swanson ◽  
Felix Proessl ◽  
Jaclyn A. Stephens ◽  
Augusto A. Miravalle ◽  
Brett W. Fling
Keyword(s):  
Multiple Sclerosis ◽  
Brain Stimulation ◽  
Lower Limb ◽  
Motor Impairment ◽  
Non Invasive

scholarly journals Reliability of a New Portable Dynamometer for Assessing Hip and Lower Limb Strength

2021 ◽  
Vol 11 (8) ◽  
pp. 3391
Author(s):  
Jan Marušič ◽  
Goran Marković ◽  
Nejc Šarabon
Keyword(s):  
Lower Limb ◽  
External Rotation ◽  
Peak Torque ◽  
Knee Extension ◽  
Lower Limb Muscles ◽  
Lower Limb Strength ◽  
Flexion Extension ◽  
Strength Tests ◽  
Hip Abduction ◽  
Maximal Peak

The purpose of this study was to evaluate intra- and inter-session reliability of the new, portable, and externally fixated dynamometer called MuscleBoard® for assessing the strength of hip and lower limb muscles. Hip abduction, adduction, flexion, extension, internal and external rotation, knee extension, ankle plantarflexion, and Nordic hamstring exercise strength were measured in three sessions (three sets of three repetitions for each test) on 24 healthy and recreationally active participants. Average and maximal value of normalized peak torque (Nm/kg) from three repetitions in each set and agonist:antagonist ratios (%) were statistically analyzed; the coefficient of variation and intra-class correlation coefficient (ICC2,k) were calculated to assess absolute and relative reliability, respectively. Overall, the results display high to excellent intra- and inter-session reliability with low to acceptable within-individual variation for average and maximal peak torques in all bilateral strength tests, while the reliability of unilateral strength tests was moderate to good. Our findings indicate that using the MuscleBoard® dynamometer can be a reliable device for assessing and monitoring bilateral and certain unilateral hip and lower limb muscle strength, while some unilateral strength tests require some refinement and more extensive familiarization.

scholarly journals Biomedical Variables and Adaptation to Disease and Health-Related Quality of Life in Polish Patients with MS

2018 ◽  
Vol 15 (12) ◽  
pp. 2678 ◽  
Author(s):  
Joanna Dymecka ◽  
Mariola Bidzan
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Mood Disorders ◽  
Upper Limb ◽  
Lower Limb ◽  
Health Related Quality ◽  
Neurological Disability ◽  
Related Quality ◽  
Health Related

The aim of this research was to assess the level of adaptation to multiple sclerosis (Sclerosis multiplex; MS) and health-related quality of life (HRQoL) of the study population as well as to determine the relationship between biomedical factors related to the course of multiple sclerosis, adaptation to the disease, and HRQoL. Analysis of medical records, clinical and psychological interviews, the Extended Disability Status Scale (EDSS), Guy’s Neurological Disability Scale (GNDS), the Acceptance of Illness Scale (AIS), and the Multiple Sclerosis Impact Scale 29 (MSIS-29) were collected from 137 patients with MS. It was found that there was a relation between motor impairment, neurological disability, adaptation to illness, and HRQoL; it was also found that there were negative correlations between adaptation to illness and the severity of lower-limb disability, fatigue, mood disorders, other problems related to MS, and upper-limb disability. Of all the symptoms, lower-limb disability, fatigue, and mood disorders had the strongest relation with adaptation. All of the analysed symptoms were found to correlate with HRQoL. Of all the symptoms, HRQoL was most affected by lower- and upper-limb disability, fatigue, other MS problems, and mood disorders.

scholarly journals Lower-limb performance disparities: Implications for exercise prescription in multiple sclerosis

2014 ◽  
Vol 51 (10) ◽  
pp. 1537-1544 ◽  
Author(s):  
Rebecca D. Larson ◽  
Kevin K. McCully ◽  
Daniel J. Larson ◽  
William M. Pryor ◽  
Lesley J. White
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Exercise Prescription
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