Original article
Resistance Training Improves Gait Kinematics in Persons With Multiple Sclerosis

Presented in part to the American College of Sports Medicine, June 2–5, 2004, Indianapolis, IN.
https://doi.org/10.1016/j.apmr.2005.04.008Get rights and content

Abstract

Gutierrez GM, Chow JW, Tillman MD, McCoy SC, Castellano V, White LJ. Resistance training improves gait kinematics in persons with multiple sclerosis.

Objective

To evaluate the effects of an 8-week lower-body resistance-training program on walking mechanics in persons with multiple sclerosis (MS).

Design

Repeated-measures design, evaluating gait kinematics before and after an 8-week progressive resistance-training intervention.

Setting

Biomechanics laboratory and fitness center (with conventional, commercially available resistance-training equipment).

Participants

Eight ambulatory subjects with MS (age, 46.0±11.5y) with Expanded Disability Status Scale scores ranging from 2.5 to 5.5.

Intervention

An 8-week progressive resistance-training program.

Main Outcome Measures

Kinematic gait parameters including knee range of motion, duration of stance, swing, and double-support phases in seconds and as percentages of the stride time, percentage of stride time spent in stance, swing, and double-support phases, step length, foot angle, stride length, velocity, step width, and toe clearance for both the more affected and less affected lower limbs. Isometric strength, 3-minute stepping, fatigue, and self-reported disability were also measured.

Results

After 2 months of resistance training, there were significant increases (P<.05) in percentage of stride time in the swing phase, step length, stride length, and foot angle; and significant decreases (P<.05) in percentage of stride time in the stance and double-support phases, duration of the double-support phase, and toe clearance. Isometric leg strength improved (P<.05) in 2 of the 4 muscle groups tested. Fatigue indices decreased (P=.04), whereas self-reported disability tended to decrease (P=.07) following the training program. Three-minute stepping increased by 8.7%.

Conclusions

Resistance training may be an effective intervention strategy for improving walking and functional ability in moderately disabled persons with MS.

Section snippets

Participants

Eight subjects with MS (7 women, 1 man) with Expanded Disability Status Scale (EDSS)15 scores ranging from 2.5 to 5.5 (mean ± standard deviation [SD] age, 46.0±11.5y; height, 1.66±0.08m; mass, 77.0±19.6kg; EDSS score, 3.6±0.8) were recruited and had physician clearance for participation. To be included, subjects were diagnosed with relapsing-remitting MS (in remission) by a neurologist and had been participating in light physical activity for the previous 3 months to ensure that subjects were

Results

All subjects completed the 8-week resistance-training program (16 sessions) with no MS-related exacerbations reported. The protocol was occasionally adjusted when subjects missed days between workouts for personal reasons, although adherence remained at 100%. Three subjects reported mild muscle soreness during the first 2 weeks of training, but their symptoms resolved within 2 to 3 days.

For the more-affected limb, subjects significantly decreased the percentage of time spent in stance phase and

Discussion

We hypothesized that lower-limb resistance training in MS subjects would alter gait characteristics to more closely resemble the patterns of persons without neurologic dysfunction. We found significant increases for percentage of stride time in the swing phase, step length, stride length, and foot angle, and significant decreases in percentage of stride time in the stance and double-support phases, duration of the double-support phase, and toe clearance. These changes are more indicative of

Conclusions

This study represents the first attempt to explore the effects of resistance training on gait kinematics in ambulatory subjects with MS. Our results suggest that an 8-week resistance-training program can improve lower-extremity strength and self-reported disability in persons with MS. Our subjects’ gait changed from a more conservative to a less conservative gait, which is closer to normative values and less like the gait characteristics shared by elderly persons prone to falling. Resistance

Acknowledgments

We thank all those who made the study possible, specifically the personal trainers who sacrificed their time to improve the lives of some brave people. We also acknowledge the undergraduate student interns, without whom data collection would not have been possible.

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