https://doi.org/10.4081/ejtm.2020.9353
Perceived fatigue, lower limb muscle force and performance fatigability after a rehabilitation program in Multiple Sclerosis
Submitted: 15 September 2020
Accepted: 12 October 2020
Published: 17 November 2020
Accepted: 12 October 2020
Abstract Views: 962
PDF: 633
HTML: 5
HTML: 5
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Muscle weakness and fatigue represent frequent disabling symptoms for Multiple Sclerosis (MS) patients. We evaluated the effects of an intensive task-oriented circuit training (TOCT) on perceived fatigue, muscle strength and changes in motor performance fatigability in mildly impaired MS patients. Fifteen MS patients performed different functional scales, self-reported questionnaires and instrumental evaluations before (T0) and after (T1) TOCT. Strength and performance fatigability were analyzed during isometric knee extension and ankle dorsiflexion through an isokinetic dinamometer, recording surface EMG signals of Vastus Medialis and Tibialis Anterior. The Dinamic Gait Index, Multiple Sclerosis Impact Scale-29, Modified Fatigue Impact Scale and Multiple Sclerosis Walking Scale–12 significantly improved after training. An increase of exerted force during isometric knee extension was observed, whereas no significant changes were revealed on mechanical and electrical fatigue. Moreover, the improvement in perceived disability after treatment was related to strength increase in knee mechanical force output. The TOCT positively modifies perceived fatigue, perceived ambulatory function and knee force output in mildly impaired MS subjects, suggesting a virtuous circle between strength levels, recovery of functional skills and improved quality of life.
Schwid SR, Covington M, Segal BM, Goodman AD. Fatigue in multiple sclerosis: Current understanding and future directions. Journal of Rehabilitation Research and Development 2002;39(2):211-224.
Ramari C, Hvid LG, David AC, Dalgas U. The importance of lower-extremity muscle strength for lower-limb functional capacity in multiple sclerosis: Systematic review. Ann Phys Rehabil Med 2020;63(2):123-137.
DOI: https://doi.org/10.1016/j.rehab.2019.11.005
Rudroff T, Kindred JH, Ketelhut NB. Fatigue in multiple sclerosis: misconceptions and future research directions. Front Neurol 2016;7:122.
DOI: https://doi.org/10.3389/fneur.2016.00122
Rice CL, Vollmer TL, Bigland-Richie B. Neuromuscular responses of patients with multiple Sclerosis. Muscle & Nerve 1992;15:1123-1132.
DOI: https://doi.org/10.1002/mus.880151011
Carroll CC, Gallagher PM, Seidle ME, Trappe SW. Skeletal Muscle Characteristics of People With Multiple Sclerosis. Arch Phys Med Rehabil 2005;86:224-9.
DOI: https://doi.org/10.1016/j.apmr.2004.03.035
Kent-Braun JA, Ng AV, Castro M, et al. Strength, skeletal muscle composition, and enzyme activity in multiple sclerosis. J Appl Physiol 1997;83:1998-2004.
DOI: https://doi.org/10.1152/jappl.1997.83.6.1998
De Haan A, De Ruiter CJ, Van der Woude LHV, Jongen PJH. Contractile properties and fatigue of quadriceps muscles in Multiple Sclerosis. Muscle Nerve 2000;23:1534–1541.
DOI: https://doi.org/10.1002/1097-4598(200010)23:10<1534::AID-MUS9>3.0.CO;2-D
Braley TJ, Chervin RD. Fatigue in Multiple Sclerosis: Mechanisms, Evaluation, and Treatment. Sleep 2010;33(8):1061–1067.
DOI: https://doi.org/10.1093/sleep/33.8.1061
Stroud NM, Minahan CL. The impact of regular physical activity on fatigue, depression and quality of life in persons with multiple sclerosis. Health Qual Life Outcomes 2009;7:68.
DOI: https://doi.org/10.1186/1477-7525-7-68
Pilutti LA, Greenlee TA, Motl RW, Nickrent MS, Petruzzello SJ. Effects of exercise training on fatigue in multiple sclerosis: a meta-analysis. Psychosom Med 2013;75(6):575-80.
DOI: https://doi.org/10.1097/PSY.0b013e31829b4525
Andreasen A, Stenager E, Dalgas U. The effect of exercise therapy on fatigue in multiple sclerosis”. Mult Scler 2011;17:1041-1054.
DOI: https://doi.org/10.1177/1352458511401120
Asano M, Berg E, Johnson K, Turpin M, Finlayson ML. A scoping review of rehabilitation interventions that reduce fatigue among adults with multiple sclerosis. Disabil Rehabil 2015;37(9):729–738.
DOI: https://doi.org/10.3109/09638288.2014.944996
Gehlsen GM, Grigsby SA, Winant DM. Effects of an aquatic fitness program on the 24 muscular strength and endurance of patients with multiple sclerosis Phys Ther 1984;64:653–657.
DOI: https://doi.org/10.1093/ptj/64.5.653
Surakka J, Romberg A, Ruutiainen J, Aunola S, Virtanen A, Karppi SL, Mäentaka K. Effects of aerobic and strength exercise on motor fatigue in men and women with multiple sclerosis: a randomized controlled trial. Clin Rehabil 2004;18(7):737-46.
DOI: https://doi.org/10.1191/0269215504cr780oa
Hameau S, Bensmail D, Roche N and Zory R. Adaptations of fatigue and fatigability after a 12 short intensive, combined rehabilitation program in patients with multiple sclerosis. J Rehabil Med 2018;50:59-66.
DOI: https://doi.org/10.2340/16501977-2277
Beretta-Piccoli M, Cescon C, Barbero M, Villiger M, Clijsen R, Kool J, Kesselring J, Bansi J. Upper and lower limb performance fatigability in people with multiple sclerosis investigated through surface electromyography: a pilot study. Physiol Meas 2020;41(2):1-27.
DOI: https://doi.org/10.1088/1361-6579/ab6f54
Tramonti C, Di Martino S, Chisari C. An intensive task-oriented circuit training positively impacts gait biomechanics in MS patients. NeuroRehabilitation. 2020. Epub ahead of print.
DOI: https://doi.org/10.3233/NRE-192997
Scott SM. Surface EMG characteristics of people with multiple sclerosis during static contractions of the knee extensors. Clin Physiol Funct Imaging 2011;31(1):11-7.
DOI: https://doi.org/10.1111/j.1475-097X.2010.00972.x
Merletti R, Lo Conte LR, Orizio SC. Indices of Muscle Fatigue. Journal of Electromyography and Kinesiology 1991;1(1):20-33.
DOI: https://doi.org/10.1016/1050-6411(91)90023-X
Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lubli FD, Montalban X, O’Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria”. Annuals of Neurology 2011;69:292–302.
DOI: https://doi.org/10.1002/ana.22366
Kurtzke JF. Rating neurological impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983;33:1444-1452.
DOI: https://doi.org/10.1212/WNL.33.11.1444
Bennett SE, Bromley LE, Fisher NM, Tomita MR, Niewczyk P. Validity and Reliability of Four Clinical Gait Measures in Patients with Multiple Sclerosis. Int J MS Care 2017;19(5):247-252.
DOI: https://doi.org/10.7224/1537-2073.2015-006
Riazi A, Hobart JC, Lamping DL, Fitzpatrick R, Thompson AJ. Evidence-based measurement in multiple sclerosis: the psychometric properties of the physical and psychological dimensions of three quality of life rating scales. Mult Scler 2003;9(4):411-9.
DOI: https://doi.org/10.1191/1352458503ms929oa
Learmonth YC, Dlugonski D, Pilutti LA, Sandroff BM, Klaren R, Motl RW. Psychometric properties of the Fatigue Severity Scale and the Modified Fatigue Impact Scale. J Neurol Sci 2013;331(1-2):102-107.
DOI: https://doi.org/10.1016/j.jns.2013.05.023
Hobart JC. Measuring the impact of MS on walking ability: the 12-Item MS Walking Scale (MSWS-12). Neurology 2003;60(1):31–6.
DOI: https://doi.org/10.1212/WNL.60.1.31
Tramonti C, Rossi B, Chisari C. Extensive Functional Evaluations to Monitor Aerobic Training in Becker Muscular Dystrophy: A Case Report. Eur J Transl Myol 2016;26(2):5873.
DOI: https://doi.org/10.4081/ejtm.2016.5873
Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol 2000;10(5):361-74.
DOI: https://doi.org/10.1016/S1050-6411(00)00027-4
Moss-Morris R, Harrison AM, Safari R, Norton S, Van der Linden ML, Picariello F, Thomas S, White C, Mercer T. Which behavioural and exercise interventions targeting fatigue show the most promise in multiple sclerosis? A systematic review with narrative synthesis and meta-analysis. Behav Res Ther 2019. Epub ahead of print.
Tantucci C, Massucci M, Piperno R, Grassi V, Sorbini C. Energy cost of exercise in multiple sclerosis patients with a low degree of disability. Mult Scler 1996;2:161-67.
DOI: https://doi.org/10.1177/135245859600200307
Guicciardi M, Carta M, Pau M, Cocco E. The Relationships between Physical Activity, Self-Efficacy, and Quality of Life in People with Multiple Sclerosis. Behav. Sci 2019;9(121):1-9.
Stoll T, Huber E, Seifert B, Michel BA, Stucki G. Maximal Isometric Muscle Strength: Normative Values and Gender-Specific Relation to Age. Clinical Rheumatology 2000;19(2):105-13.
DOI: https://doi.org/10.1007/s100670050026
Haraldstad K, Rohde G, Stea TH, Lohne-Seiler H, Hetlelid K, Paulsen G, Berntsen S. Changes in health-related quality of life in elderly men after 12 weeks of strength training. Eur Rev Aging Phys Act 2017;14(8):1-6.
DOI: https://doi.org/10.1186/s11556-017-0177-3
How to Cite
Tramonti, C., Di Martino, S., Fogia, A., & Chisari, C. (2020). Perceived fatigue, lower limb muscle force and performance fatigability after a rehabilitation program in Multiple Sclerosis. European Journal of Translational Myology, 30(4). https://doi.org/10.4081/ejtm.2020.9353
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.