title: A systematic review and meta-analysis of strength training in individuals with multiple sclerosis or Parkinson disease.
abstract: Strength training has, in recent years, been shown to be beneficial for people with Parkinson disease and multiple sclerosis. Consensus regarding its utility for these disorders nevertheless remains contentious among healthcare professionals. Greater clarity is required, especially in regards to the type and magnitude of effects as well as the response differences to strength training between individuals with Parkinson disease or multiple sclerosis. This study examines the effects, magnitude of those effects, and response differences to strength training between patients with Parkinson disease or multiple sclerosis. A comprehensive search of electronic databases including Physiotherapy Evidence Database scale, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL was conducted from inception to July 2014. English articles investigating the effect of strength training for individuals with neurodegenerative disorders were selected. Strength training trials that met the inclusion criteria were found for individuals with Parkinson disease or multiple sclerosis. Individuals with Parkinson disease or multiple sclerosis were included in the study. Strength training interventions included traditional (free weights/machine exercises) and nontraditional programs (eccentric cycling). Included articles were critically appraised using the Physiotherapy Evidence Database scale. Of the 507 articles retrieved, only 20 articles met the inclusion criteria. Of these, 14 were randomized and 6 were nonrandomized controlled articles in Parkinson disease or multiple sclerosis. Six randomized and 2 nonrandomized controlled articles originated from 3 trials and were subsequently pooled for systematic analysis. Strength training was found to significantly improve muscle strength in people with Parkinson disease (15%-83.2%) and multiple sclerosis (4.5%-36%). Significant improvements in mobility (11.4%) and disease progression were also reported in people with Parkinson disease after strength training. Furthermore, significant improvements in fatigue (8.2%), functional capacity (21.5%), quality of life (8.3%), power (17.6%), and electromyography activity (24.4%) were found in individuals with multiple sclerosis after strength training. The limitations of the study were the heterogeneity of interventions and study outcomes in Parkinson disease and multiple sclerosis trials. Strength training is useful for increasing muscle strength in Parkinson disease and to a lesser extent multiple sclerosis.
authors: From the School of Medical Sciences (TMC, ARR, MRZ), Edith Cowan University; and School of Pathology and Laboratory Medicine (MRZ), University of Western Australia, Perth, Australia.
authors: Travis M
authors: TM
authors: Cruickshank
authors: Alvaro R
authors: AR
authors: Reyes
authors: Melanie R
authors: MR
authors: Ziman
mesh_terms: D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D004576:Electromyography; D005221:Fatigue / Q000503:physiopathology / Q000628:therapy; D005979:Glutathione Peroxidase / Q000097:blood; D006801:Humans; D006861:Hydrogen Peroxide / Q000097:blood; D008315:Malondialdehyde / Q000097:blood; D051346:Mobility Limitation; D009103:Multiple Sclerosis / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D053580:Muscle Strength / Q000502:physiology; D010300:Parkinson Disease / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D004856:Postural Balance / Q000502:physiology; D011788:Quality of Life; D055070:Resistance Training; D013482:Superoxide Dismutase / Q000097:blood
chemical_list: D015415:Biomarkers; D008315:Malondialdehyde; D006861:Hydrogen Peroxide; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase
references: Arch Phys Med Rehabil. 2005 Feb;86(2):224-9
references: 15706547
references: J Physiother. 2013 Mar;59(1):7-13
references: 23419910
references: Circulation. 2007 Aug 28;116(9):1094-105
references: 17671236
references: Neurology. 2009 May 26;72(21 Suppl 4):S1-136
references: 19470958
references: Mov Disord. 2006 Sep;21(9):1444-52
references: 16773643
references: Neurology. 2011 Jul 26;77(4):355-63
references: 21775734
references: Int J Surg. 2010;8(5):336-41
references: 20171303
references: Arch Phys Med Rehabil. 1984 Mar;65(3):135-8
references: 6703889
references: Mult Scler. 2013 Oct;19(11):1526-32
references: 23439577
references: Med Sci Sports Exerc. 2007 Aug;39(8):1401-7
references: 17762374
references: Arch Phys Med Rehabil. 2013 Aug;94(8):1443-50
references: 23602881
references: Adv Neurol. 1990;53:259-69
references: 2239464
references: Aust J Physiother. 2006;52(4):241-8
references: 17132118
references: Mult Scler. 2012 Sep;18(9):1215-28
references: 22760230
references: J Neurophysiol. 2000 Jan;83(1):528-36
references: 10634893
references: Gait Posture. 2012 Apr;35(4):669-73
references: 22266107
references: Exp Gerontol. 2012 Mar;47(3):250-5
references: 22234287
references: JAMA Neurol. 2013 Feb;70(2):183-90
references: 23128427
references: Muscle Nerve. 2004 Jun;29(6):843-52
references: 15170617
references: Parkinsons Dis. 2010 Mar 16;2010:824734
references: 20976096
references: Parkinsonism Relat Disord. 2010 May;16(4):261-4
references: 20117036
references: Mult Scler. 2001 Oct;7(5):340-4
references: 11724451
references: Neuroscience. 2013 Jun 14;240:106-16
references: 23454540
references: Age (Dordr). 2013 Jun;35(3):891-903
references: 22453934
references: Mult Scler. 2011 Apr;17(4):468-77
references: 21148266
references: Stroke. 2004 Jun;35(6):1404-9
references: 15105515
references: Mult Scler. 2011 Nov;17(11):1362-74
references: 21677021
references: Ann Neurol. 1996 Jan;39(1):79-88
references: 8572671
references: J Neurol. 2013 Jul;260(7):1822-32
references: 23483214
references: Mult Scler. 2011 Sep;17(9):1041-54
references: 21467189
references: Clin Rehabil. 2014 Mar;28(3):275-88
references: 24188914
references: Curr Neurol Neurosci Rep. 2012 Aug;12(4):359-66
references: 22544535
references: Phys Ther. 2010 Dec;90(12):1711-5
references: 21123213
references: Mov Disord. 2008 Jan;23(1):1-11
references: 17894327
references: Muscle Nerve. 2000 Oct;23(10):1534-41
references: 11003788
references: Neurology. 2009 Nov 3;73(18):1478-84
references: 19884575
references: Exp Brain Res. 2001 Oct;140(3):290-300
references: 11681304
references: Mult Scler. 2010 Apr;16(4):480-90
references: 20194584
references: Muscle Nerve. 2003 Apr;27(4):456-64
references: 12661047
references: Med Sci Sports Exerc. 2008 Aug;40(8):1385-9
references: 18614956
references: Mov Disord. 2013 Aug;28(9):1230-40
references: 23536417
references: Clin Rehabil. 2011 Jan;25(1):14-24
references: 20713434
references: Neuroimage. 2014 Apr 15;90:107-16
references: 24370819
references: Mult Scler. 2013 Jan;19(1):112-9
references: 22562952
references: NeuroRehabilitation. 2014;34(3):523-30
references: 24463236
references: Radiology. 2014 Nov;273(2):529-38
references: 25158046
references: Parkinsonism Relat Disord. 2009 Dec;15(10):752-7
references: 19497777
references: Mov Disord. 2013 Jul;28(8):1034-49
references: 23426759
references: Mult Scler. 2010 Nov;16(11):1367-76
references: 20685760
references: Stroke. 2010 Jan;41(1):136-40
references: 19940277
references: JAMA. 1994 Dec 28;272(24):1909-14
references: 7990242
references: Eur J Neurol. 2012 Mar;19(3):431-7
references: 21967324
references: Nat Rev Neurol. 2011 May 10;7(6):332-42
references: 21556031
references: Eur J Appl Physiol. 2010 Jun;109(3):517-25
references: 20169360
references: Eur J Appl Physiol. 2010 Sep;110(2):435-43
references: 20512584
references: J Am Med Dir Assoc. 2013 Apr;14(4):236-41
references: 23318666
references: Nature. 2006 Oct 19;443(7113):787-95
references: 17051205
references: J Neurol. 2001 Mar;248(3):174-9
references: 11355149
references: Phys Ther. 2006 Jun;86(6):817-24
references: 16737407
references: Diabetes Care. 2007 Sep;30(9):2205-10
references: 17563342
references: Phys Ther. 2003 Aug;83(8):713-21
references: 12882612
references: JAMA. 1990 Jun 13;263(22):3029-34
references: 2342214
references: Mult Scler. 2008 Jan;14(1):35-53
references: 17881393
references: J Neurosci. 2013 Mar 6;33(10):4594-604
references: 23467375
references: Neurobiol Aging. 2014 Jan;35(1):232-9
references: 23916062
references: Neurorehabil Neural Repair. 2015 Feb;29(2):112-22
references: 24961994
references: Neurology. 2012 Sep 11;79(11):1130-5
references: 22933738
references: Lancet. 2007 Jun 16;369(9578):2031-2041
references: 17574095
references: Arch Intern Med. 2012 Apr 23;172(8):666-8
references: 22529236
references: Neurorehabil Neural Repair. 2013 Jan;27(1):63-71
references: 22623207
references: J Neurol Neurosurg Psychiatry. 2011 Oct;82(10):1112-8
references: 21593513
references: Eur J Phys Rehabil Med. 2013 Feb;49(1):59-66
references: 22820825
references: Arch Intern Med. 2010 Jan 25;170(2):170-8
references: 20101012
references: Phys Ther. 1998 Jun;78(6):566-76
references: 9626269
references: J Appl Physiol (1985). 1997 Dec;83(6):1998-2004
references: 9390973
references: Arch Phys Med Rehabil. 2004 Feb;85(2):290-7
references: 14966716
references: J Neurophysiol. 1995 Aug;74(2):802-15
references: 7472384