The Effect of Combined Exercises on Neural Drive and Muscle Strength in Females with ‎Multiple Sclerosis

Document Type : Original Article

Authors

1 Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Isfahan University, Isfahan, Iran

2 Department of Motor Behavior, Faculty of Sport Science, University of Isfahan, Isfahan, Iran.

3 Department of Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of Physical Education, Faculty of Humanities, Saveh Azad University, Saveh, Iran

Abstract

Purpose:
Multiple Sclerosis (MS) is a chronic disease of the central nervous system which leads to myelin destruction and dysfunction in nerve conduction. Reducing nervous stimulation and decreased muscle strength are debilitating symptoms and complications of the disease. Practicing therapy is a very important therapeutic approach to reduce the symptoms of the disease, to reduce the level of disability and to improve the independence of MS patients. The purpose of this study was to evaluate the effect of eight weeks of combined exercises on neural drive, strength of women with MS.
Methods:
Twenty female MS patients were selected and randomly assigned in to the experimental group (mean ± SD; age 38.7 ± 7.24 years, height 1.56 ± 5.84 cm and weight 46.1 ± 9.87 kg) and control group (mean ± SD; age 40.1 ± 5.64 years, height 1.58 ± 6.04 cm, and weight 55.5 ± 11 kg). The combined exercise program (flexibility, strength, balance, central stability, agility and plyometric) was performed for 8 weeks, 3 times per week, 45 min per session for the experimental group. In order to investigate the neural drive of the rectus femoris muscle, vastus lateralis muscle and semitendinosus muscle (Electromyography), muscular strength of quadriceps and hamstring muscles (Biodex). Data were analyzed by repeated measures ANOVA test (p<0.05).
Result:
Eight weeks, combined exercise significantly improved in the neural drive of the rectus femoris muscle (p<0.05), vastus lateralis muscle (p<0.05) and semitendinosus muscle (p<0.05). Also, the exercise protocol significantly improved the strength of quadriceps muscles (p<0.05) and knee hamstrings of patients (p<0.05) with MS (p<0.05).
Conclusion:
According to the present study, combined exercises can be used to improve the symptoms of muscle weakness and increase nervous excitability in people with MS. It could be recommended as a modality for this patient.

Keywords

References

  1. Neurorehabilitation for the Physical Therapist Assistant. 1ed. Slack Incorporated.2006; 198202.
  2. Soltani M, Hejazi SM, Noorian A, Zendedel A, Ashkanifar M. Effect of Selected Aerobic Exercise on Balance Improvement in Multiple Sclerosis Patients. J Mashhad School Nurs Midw 2009; 9(2): 107-113. [Persian]
  3. Sokhangu MK, Rahnama N, Etemadifar M, Rafeii M, Saberi A. Effect of neuromuscular exercises on strength, proprioceptive receptors, and balance in females with multiple sclerosis. Int J Prev Med 2021; 12: 5.
  4. Kargarfard M, Shariat A, Ingle L, A. Cleland J, Kargarfard M. Randomized Controlled Trial to Examine the Impact of Aquatic Exercise Training on Functional Capacity, Balance, and Perceptions of Fatigue in Female Patients With Multiple Sclerosis. Archive of Physical Medicine and Rehabilitation. 2018; 99: 234-241.
  5. Charles  L, Timothy L,  Bigland-Ritchie B. Neuromuscular Response of Patients with multiple sclerosis. Muscle & Nerve 1992 ;15: 1123-1132.
  6. Scott S, Hughes A, Galloway S,  Hunter A. Surface EMG characteristics of people with multiple sclerosis during static contractions of the knee extensors. Clin Physiol Funct Imaging 2011; 31: 11-17.
  7. Stevenson J, Chad S, Schwartz B,  Busconi D. Assessing the Effectiveness of Neuromuscular Training Programs in Reducing the Incidence of Anterior Cruciate Ligament Injuries in Female Athletes: A Systematic Review. Am J Sports Med 2015; 43(2): 482-90.
  8. Fimland M, Gruber M, Hoff J, Helgerud J,  Leivseth G. Enhanced neural drive after maximal strength training in multiple sclerosis patients. Eur J Appl Physiol 2010; 110: 435-443.
  9. Schwid SR, Thornton CA, Pandya S, Manzur KL, et al. Quantitative assessment of motor fatigue and strength in MS. Neurology 1999 ; 53(4): 743-750.
  10. Kjlhede T, Vissing K, de Place L, Pedersen B, et al. Neuromuscular adaptations to long-term progressive resistancetraining translates to improved functional capacity for people with multiple sclerosis and is maintained at follow-up. Multiple Sclerosis Journal  2015; 21(5): 599-611.
  11. Frey GC, Chow B. Relationship between BMI, physical fitness and motor skills in youth with mild intellectual disabilities. Int J Obes (Lond). 2006; 30(5): 861-867.
  12. Kjhede T, Vissing K,  Dalgas U. Multiple sclerosis and progressive resistance training: a systematic review . Mult Scler  2012; 18(90): 1215-1228.
  13. Dalgas U, Stenager E, Rasmussen C, Lund C, et al. Neural drive increases following resistance training in patients with multiple sclerosis. Neurol Journal 2013; 260(7): 1822-1832.
  14. Tarakci E, Yelden I, Huseyinsinoglu B, Zenginler Y, Eraksoy M. Group exercise training for balance, functional status, spasticity, fatigue and quality of life in multiple sclerosis: a randomized controlled trail. Clin Rehabil 2013; 27(9): 813-822.
  15. Mayo NE, Bayley M, Duquette P, Lapierre Y, et al. The role of exercise in modifying outcomes for people with multiple sclerosis: a randomized trial. BMC Neurology 2013; 13(1): 69.
  16. Vight M,  Cook G. Sports Wounds Chapter 9 Impaired neuromuscular control: Reactive neuromuscular training 2014.
  17. A.Gabriel D, Kamen G, Frost G. Neural Adaptations to Resistive Exercise. Sport Med 2006; 36(2): 133-149.
  18. Samuel R. Importance of Neuromuscular Training of Athletes. Sport Studies 2015; 5(2): 141-145.
  19. Etemadifar M,  Maghzi AH. Sharp increase in the incidence and prevalence of multiple sclerosis in Isfahan, Iran. Mult Scler 2011; 17(8): 1022-1027.
  20. Hermens HJ, Freriks B, Disselhorst C, Rau G. Development of recommendations for sEMG sensor placement procedures. J Electromyogr Kinesiol 2000; 10(5): 361-374.
  21. M.Lepez N, Orosco E,  di Sciascio F. Surface Electromyographic Onset Detection Based on Statistics and Information Content. Jomdas de Ingeniera Clinical. 2011.
  22. Clausen B, Holsgaard-Larsen A, Ewa M. An 8-Week Neuromuscular Exercise Progra m for Patients With Mild to Moderate Knee Osteoarthritis: A Case Series Drawn From a Registered Clinical Trial. J Athl Train 2017; 52(6): 592-605.
  23. A.Gabriel D, Kamen G, Frost G. Neural Adaptations to Resistive Exercise. Sport Med 2006; 36 (2): 133-149.
  24. Aagaard P, Simonsen E, Andersen J, Magnusson P. Increased rate of force development and neuraldrive of human skeletal muscle following resistance training. J Appl Physiol 2002; 93:1318-1326.
  25. Angelozzi M, Madama M, Corsica C, Vittorio C, et al. Rate of force development as an adjunctive outcome measure for return-to-sport decisions after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 2012; 42(9): 72-78.
  26. Gorassini M, Yang J, Siu M, Bennett D. Intrinsic activation of human motor units:Reduction of motor unit recruitment thresholds by repeated contractions. J Neurophysiol 2002; 87(4): 1859-1866.
  27. Gondin J, Guette M, Ballay Y,  Martin A. Electromyostimulation Training Effects on Neural Drive and Muscle Architecture. Journal of the American College of Sports Medicine 2005: 1291-1299.
  28. Behrens M, Mau-Moeller A, Bruhn S. Effect of plyometric training on neural and mechanical properties of the knee extensor muscles. Int J Sport Med 2014; 35(2): 101-110.
  29. Villadsen A, Overgaard S, Holsgaard-Larsen A, Christensen R, Roos E. Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee:. A Secondary Analysis from a Randomized Controlled Trial. J Rheumatol 2014;41:1394-1385.
  30. Learmonth YC, Paul L, Miller L, Mattison P, McFadyen AK. The effects of a 12-week leisure centre-based, group exercise intervention for people moderately affected with multiple sclerosis: a randomized controlled pilot study. Clin Rehabil 2012; 26(7): 579-593.
  31. Hopper A, Haff E, Barley O, Joyce C, et al. Neuromuscular Training Improves Movement Competency and Physical Performance Measures in 11–13 Year-Old Female Netball Athletes. J Strength Condg Res 2017; 31(5): 1165-1176.
  32. Chmielewski T, D.Myer G, Kauffman D, M. Tillman S. Plyometric Exercise in the Rehabilitation of Athletes: Physiological Responses and Clinical Application. J Orthop Sports Phys Ther 2006; 36(5): 308-319.
Journal of Paramedical Sciences & Rehabilitation
Volume 11, Issue 2
August 2022
Pages 68-80

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