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Effects of High-Intensity Resistance Training on Strength, Mobility, Balance, and Fatigue in Individuals With Multiple Sclerosis: A Randomized Controlled Trial

Hayes, Heather A. DPT, NCS; Gappmaier, Eduard PT, PhD; LaStayo, Paul C. PT, PhD

Journal of Neurologic Physical Therapy: March 2011 - Volume 35 - Issue 1 - p 2–10
doi: 10.1097/NPT.0b013e31820b5a9d
Research Articles

Background and Purpose: Resistance exercise via negative, eccentrically induced work (RENEW) has been shown to be associated with improvements in strength, mobility, and balance in multiple clinical populations. However, RENEW has not been reported for individuals with multiple sclerosis (MS).

Methods: Nineteen individuals with MS (8 men, 11 women; age mean = 49 ± 11 years; Expanded Disability Status Scale [EDSS] mean = 5.2 ± 0.9) were randomized into either standard exercise (STAND) or standard exercise and RENEW training (RENEW) for 3×/week for 12 weeks. Outcome measures were lower extremity strength (hip/knee flexion and extension, ankle plantar and dorsiflexion, and the sum of these individual values [sum strength]); Timed Up and Go (TUG), 10-m walk, self-selected pace (TMWSS) and maximal-pace (TMWMP), stair ascent (S-A) and descent (S-D) and 6-Minute Walk Test (6MWT), Berg Balance Scale (BBS), Fatigue Severity Scale (FSS).

Results: No significant time effects or interactions were observed for strength, TUG, TMWSS, TMWMP, or 6MWT. However, the mean difference in sum strength in the RENEW group was 38.60 (representing a 15% increase) compared to the sum strength observed in the STAND group with a mean difference of 5.58 (a 2% increase). A significant interaction was observed for S-A, S-D, and BBS as the STAND group improved whereas the RENEW group did not improve in these measures.

Discussion and Conclusions: Contrary to results in other populations, the addition of eccentric training to standard exercises did not result in significantly greater lower extremity strength gains in this group of individuals with MS. Further this training was not as effective as standard exercise alone in improving balance or the ability to ascend and descend stairs. Following data collection, reassessment of required sample size indicates we were likely underpowered to detect strength differences between groups.

Department of Physical Therapy, University of Utah, Salt Lake City

Correspondence: Heather A. Hayes, PT, DPT, NCS, Department of Physical Therapy, University of Utah, 520 Wakara Way, Ste 302, Salt Lake City, UT 84108 (

© 2011 Neurology Section, APTA