Resistance Training in Ms Patients Found to Improve Hip Strength, Walking Ability

Researchers at the Kennedy Krieger Institute and Johns Hopkins University School of Medicine released preliminary results of an ongoing study into an effective and progressive resistance training program to improve hip strength and walking ability, areas of concern in neurodegenerative diseases like multiple sclerosis (MS). The program, consisting of exercises using resistant elastic bands adapted to different levels of disability, was found to improve strength in MS patients in the trial’s first eight weeks.

The article describing the methodology of the design, implementation, and results of the resistance strength training (RST) program, published in the JoVE Journal, is titled “Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis.”

The protocol, according to study leader Dr. Kathleen M. Zackowski, addresses hip weakness, a primary impairment affecting the quality of life for people with MS and other neurodegenerative diseases. The elastic band exercises are presented in a straightforward and simple manner, providing the patient an easy and inexpensive exercise to strengthen core mobility muscles, a press release said.

Moreover, the exercises can be used in a group setting, and be modified to accommodate differing levels of muscle weakness (asymmetric, profound or mild), emphasizing proper strength and alignment for the muscles used in walking.

The National Multiple Sclerosis Society-funded study assessed the efficacy of a 12-week progressive resistance program in a group of 30 MS patients and 30 healthy controls. The procedure consists, firstly, of a proper explanation of the exercise, followed by the assessment of motor and functional impairments, including baseline strength of the hip flexor, hip extensor, and hip abductor muscles through a break test.

Prior to each exercise, participants are instructed to look at the exercise log and choose the level of resistance most appropriate for them. Weaker participants are assigned less aggressive forms of some exercises. The workout consist of repetition of a core group of movements — hip flexion, hip abduction, hip extension, hip external rotation, knee extension, and knee flexion — and each person was given an individualized exercise program to continue over the weekend.

At eight weeks,  statistically significant hip strength and symmetry improvements were seen in individuals with differing degrees of disability. Observing change at eight weeks is an important measure in  designing clinical trials for pharmacological or rehabilitative interventions.

An instructional video, with exercise demonstrations and comments regarding patient compliance and instructor motivation by the researchers, is available through this link.

“Future application of this protocol in the home will provide greater opportunity for more individuals to benefit from this program,” Dr. Zackowski concluded in the video.