Gait impairments are highly prevalent in PwMS and have been found to vary in severity and correlate with deterioration of muscle strength. Hence, ST has been regarded as a promising avenue for PwMS although its effectiveness in promoting improvements in gait were unsubstantiated. The purpose of this review was to explore and evaluate the literature surrounding the effectiveness of ST in improving gait in PwMS. Following the analysis of four studies, ST could not be confirmed as effective in improving gait; as was the case in the works of Brændvik et al., (2015) Callesen et al., (2019) and Dodd et al., (2011), although outcome measure disparities and ST intervention selections were identified as potential factors influencing the findings. However, an alternate approach utilised by Manca et al. (2020) in carrying out DST of the ankle dorsiflexors saw significant improvements in gait speed and quality. When considering the lack of supporting evidence uncovered, it can be concluded that moderate intensity ST over a period of 6-10 weeks should not be recommended clinically for the purpose of improving gait in PwMS. Future investigations should explore the effectiveness of higher intensity, task-specific ST applied over a longer intervention period to a greater range of disability levels.
Table of Contents
Introduction
Methodology
Data collection
Results
Discussion
Gait outcome measures; speed, endurance and quality
Interventions
Sample populations and study designs
Conclusion
References
Research Objectives and Themes
This review aims to explore and evaluate existing scientific literature to determine the effectiveness of strength training (ST) as a therapeutic intervention for improving gait performance in individuals living with multiple sclerosis (PwMS).
- The impact of strength training on walking speed and quality.
- Evaluation of gait endurance improvements in multiple sclerosis patients.
- Analysis of training parameters, including intensity, volume, and frequency.
- Comparison of various study designs and outcome measurement methodologies.
- Identification of gaps in current rehabilitation research for MS patients.
Excerpt from the Book
Gait outcome measures; speed, endurance and quality
The selection of outcome measures varied greatly across each study, limiting the ability to directly compare gait changes generated by ST. Accordingly, the range of outcomes can be classified as gait speed, endurance or quality to ensure comparability. Gait speed constitutes a number of measures utilised by the authors; Brændvik et al. (2015) incorporated gait speed into an arbitrary Functional Ambulant Profile (FAP) score, failing to significantly improve following ST intervention (-1.4, p = .844). Similar findings arose in the works of Callesen et al. (2019) and Dodd et al. (2011) as the PRT groups in each study saw insignificant increases in Timed 25 Foot Walk (T25FW; .02m/s, p = 0.08) and Fast Walking Speed (FWS; 0.5m/s) scores, respectively. These results are unexpected when considering that the ST interventions within each of the aforementioned studies incorporated knee flexion and extension exercises and a significant relationship has been previously identified between hamstring and quadriceps strength and gait speed (Thoumie et al., 2005). Further contradicting this, gait speed was found to significantly increase (0.14m/s, p < .0001) by Manca et al. (2020) following DST of the ankle dorsiflexors.
Gait endurance has been shown to undergo deterioration at greater rates than speed in PwMS, likely correlating with the prevalence of increased fatigue levels (Filli et al., 2018). Brændvik et al. (2015) measured gait endurance in the form of Walking Work Economy (WWE), serving as a limitation of the study as explanation of the measure’s logistics, and its implications on endurance, was minimal, potentially generating interpretation bias. Therefore, it can only be assumed that ST did not improve gait endurance as WWE saw no significant improvement, (-.68kg/L, p = 0.061) with similar, more concrete results emerging from the work of Dodd et al. (2011) as PRT failed to significantly enhance Two Minute Walk Test scores (2.8m) (Brændvik et al., 2015).
Summary of Chapters
Introduction: Provides an overview of multiple sclerosis, highlighting the prevalence of gait impairments and the potential role of strength training as a rehabilitation strategy.
Methodology: Details the search strategy used to identify relevant peer-reviewed literature between 2010 and 2020 across four academic databases.
Data collection: Describes the process of extracting and tabulating information from selected studies, including participant demographics, intervention details, and outcomes.
Results: Outlines the findings of the systematic literature search, including the selection process based on PRISMA flow diagram protocols.
Discussion: Critically analyzes and compares the results of the selected studies regarding gait speed, quality, and endurance, while addressing discrepancies in methodology.
Gait outcome measures; speed, endurance and quality: Examines how different measurement tools and their limitations impact the ability to compare gait performance across studies.
Interventions: Evaluates the consistency of strength training protocols, focusing on variables like training volume, frequency, and exercise selection.
Sample populations and study designs: Analyzes the influence of participant disability levels and research design on the internal and external validity of the findings.
Conclusion: Synthesizes the evidence, noting that moderate-intensity strength training is not currently supported as a primary method for improving gait in PwMS and suggests future research directions.
References: Lists the academic sources and clinical studies cited throughout the review.
Keywords
Multiple Sclerosis, Strength Training, Resistance Training, Gait, Walking Speed, Rehabilitation, Physiotherapy, Gait Endurance, Muscle Weakness, Clinical Review, Motor Control, Disability Levels, Exercise Prescription, Functional Outcomes, Gait Ataxia
Frequently Asked Questions
What is the primary focus of this research paper?
The paper evaluates the effectiveness of strength training (ST) as a therapeutic intervention for improving gait and mobility in individuals diagnosed with multiple sclerosis.
Which specific areas of gait performance are discussed?
The research focuses on three main components of gait: walking speed, endurance, and gait quality (including stability and stride mechanics).
What is the central research question addressed in this work?
The core inquiry is whether various forms of strength training can effectively restore or improve gait dysfunction in patients suffering from the effects of multiple sclerosis.
What scientific methodology was applied to reach the conclusions?
The author conducted a literature review of four specific, high-quality studies from the period 2010–2020, comparing their intervention protocols, sample sizes, and outcome measurements.
What is covered in the main body of the text?
The main body examines the results of selected studies, critiques the consistency of training interventions, analyzes the impact of different measurement metrics, and addresses the limitations regarding study populations and research designs.
Which key terms characterize this research?
Relevant keywords include Multiple Sclerosis, Resistance Training, Gait Ataxia, Physiotherapy, and Clinical Rehabilitation.
Did the review find strength training to be universally effective for MS patients?
No, the review indicates that moderate-intensity strength training as typically applied (e.g., knee and hip exercises) did not consistently improve gait outcomes in the analyzed studies.
What makes the findings of Manca et al. (2020) different from other studies?
Manca et al. (2020) demonstrated significant improvements in gait speed and quality through direct strength training (DST) specifically targeting ankle dorsiflexors, which contrasted with the findings of the other reviewed studies.
Why are standard 6-10 week moderate-intensity training programs currently not recommended by the author?
Based on the lack of consistent evidence across most studies, the author concludes that these specific programs are insufficient for addressing complex gait impairments in this patient population.
What future research is suggested by the author?
The author suggests that future investigations should test higher-intensity, task-specific training, longer intervention durations, and include a broader spectrum of disability levels.
- Quote paper
- Samuel Lehmann (Author), 2020, The Effect of Strength Training on Gait for Individuals with Multiple Sclerosis, Munich, GRIN Verlag, https://www.grin.com/document/903765
