Category: Neurodegenerative Disease (e.g. MS, Parkinson's disease); Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
To evaluate the effects of bilateral isokinetic quadriceps and hamstring strength training on muscle strength, knee joint position sense (JPS), pain, kinesiophobia, and quality of life (QoL) in patients with multiple sclerosis (MS).
Design : prospective randomized trial
Setting : physical medicine and rehabilitation outpatient clinic of a tertiary healthcare center
Participants (or Animals, Specimens, Cadavers) : Fifty patients who met the inclusion criteria were enrolled in the study and randomized into two training groups: Group 1 underwent isokinetic strength training, whereas Group 2 was recommended home exercises.
Interventions : Group 1 underwent bilateral isokinetic quadriceps and hamstring strength training, whereas Group 2 was recommended home exercises which consist of lower extremity strengthening and balance exercises.
Main Outcome Measure(s) : The outcome measures were the peak torque/body mass index (PT/BMI) of quadriceps and hamstring muscles at 60°/s and 180°/s velocities, the hamstring/quadriceps (H/Q) ratios at the same velocities, absolute angular errors (AAEs) and the mean absolute error (MAE) of the 15°, 45° and 60° JPS of the less and more affected knees, and the scores of Multiple Sclerosis Quality of Life-54 (MSQoL-54), Visual Analogue Scale (VAS), and Tampa Scale of Kinesiophobia (TSK).
Results : In Group 1, 60°/s and 180°/s PT/BMI of quadriceps and hamstring in the less affected knee (p:0.02, p:0.002, p:0.001, p:0.005) and more affected knee (p:0.001, p:0.001, p:0.002, p:0.023), the AAE and MAE of the 15° JPS of the less affected knee (p:0.028, p:0.013), and the physical subscore of MSQoL-54 (p:0.047) improved significantly after the training program. In Group 2, only 60°/sPT/BMI of quadriceps and hamstring of the less affected knee improved (p:0.038, p:0.011). Improvements in 60°/s PT/BMI of quadriceps and hamstring (p:0.006, p:0.041), 180°/s PT/BMI of quadriceps (p:0.001), and the MAE of the 15° JPS (p:0.047) of the less affected knee, 60°/s PT/BMI of quadriceps and hamstring (p:0.003, p:0.002) and 180°/s H/Q ratio (p:0.013) of the more affected knee, and the total and physical scores of MSQoL-54 (p:0.044, p:0.006) were better than those of Group 2 (p<0.05).
Conclusions : Bilateral isokinetic quadriceps and hamstring strength training can improve muscle strength, knee JPS, and QoL in patients with MS without complications and exacerbation.
Melek aykut selçuk– Physical Medicine and Rehabilitation Specialist, ankara akyurt public hospital, Ankara, Ankara
Burcu duyur çakıt– Physical Medicine and Rehabilitation Specialist, Ankara Training and Research Hospital, Ankara, Ankara
Ufuk Ergün– Neurology, kırıkkale university medical faculty, kırıkkale, Kirikkale