Figures
Effects of a 6-week unilateral resistance training program on the peak moment (PM) recorded from both the less-affected (LA) trained and more-affected (MA) untrained ankle dorsiflexors. The graphs report individual results obtained in all phases of the study (A1=pretest, B=intermediate, A2=posttest, A3=follow-up) for PM at 45°/s (continuous line) and at 10°/s (dashed line). To adhere to the cross-education paradigm,11 during phase B, the PM was assessed in each of the scheduled training sessions in the trained limb (left panel), and a single intermediate measurement was performed, in the middle of the intervention period, in the untrained limb (right panel). As the PM values of each participant were quite different at baseline, the ordinates in each graph are enhanced to emphasize as much as possible the variations of PM throughout the entire duration of the study. Missing points during phase B indicate that participants 1 and 4 missed the last training session. Missing points during phase A3 indicate that participant 5 missed the follow-up assessment due to dropout.
Time line of the study. A1=pretraining phase (baseline) with test-retest procedures consisting of 3 bilateral measurements (test, 1-day retest, and 1-week retest) of maximal strength (peak moment and maximal work at 10°/s and 45°/s of angular velocity) from the dorsiflexor muscles of both sides. B=intervention phase consisting of 6 weeks of training (3 sessions per week) of the less-affected ankle dorsiflexors (upper panel) while leaving the more-affected limb untrained (lower panel). According to the cross-education paradigm,11 during phase B, multiple measurements (one for each of the 18 scheduled sessions) of maximal strength were obtained only from the less-affected trained limb (upper panel), while performing only one single measurement (intermediate) in a separate session after completing 3 weeks of training in the middle of phase B from the untrained more-affected ankle dorsiflexors. A2=posttraining test-retest procedures where 2 measurements (test, 1-day retest) of maximal strength were performed in both limbs within 1 week from the end of phase B. Follow-up=12-week period of follow-up, with no intervention administered for both limbs. A3=2 assessments (follow-up) as in phase A2, carried out within 1 week after the follow-up period. Arrows with continuous line indicate each resistance training session administered to the less-affected ankle dorsiflexors. Arrows with dashed line indicate the number of assessments performed in both limbs in phases A1 (pretest), B (intermediate), A2 (posttest), and A3 (follow-up).
Changes in maximal strength following 6-week high-intensity resistance training of the less-affected (LA) ankle dorsiflexor muscles in patients with multiple sclerosis. Changes in peak moment (PM) and maximal work (MW) are reported by angular velocity at 10°/s (A and C, respectively) and 45°/s (B and D, respectively) for the LA trained limb (continuous line) and for the more-affected (MA) untrained limb (broken line). Pretest=assessment at baseline, intermediate=assessment after 3 weeks of resistance training, posttest=assessment at the end of 6-week intervention period, follow-up=assessment after 12 weeks from the end of intervention.
Tables
Demographic and Clinical Features of the Participants at Study Entrya
↵a EDSS=Expanded Disability Status Scale, M=male, F=female, MS=multiple sclerosis, PP=primary progressive, RR=relapsing-remitting, BDI=Beck Depression Index, FAB=Functional Assessment Battery, TMT=Trail Making Test, AFO=ankle-foot orthosis.
Group-Level Assessments (N=7) of Dynamometric Outcomes at Baseline (Pretest), After a 3-Week Intervention, at the End of the 6-Week Intervention Period, and After 12 Weeks From the End of the Interventiona
↵a PM=peak moment, MW=maximal work, 45°/s=45 degrees of angular velocity per second, 10°/s=10 degrees of angular velocity per second, pretest=assessment at baseline, intermediate=assessment performed in a separate session after completing 3 weeks of training during the 6-week intervention period (multiple measurements carried out at each of the scheduled training sessions for the trained limb, with only one measurement performed at the ninth session for the untrained limb), posttest=assessment immediately after the 6-week intervention period, follow-up=assessment performed after 12 weeks from the end of the intervention. Outcome values are reported as mean (SD) and 95% confidence interval. Changes in outcome values are reported as percentages (+=increase, −=decrease), and significance of these changes is reported as P values, which were calculated by repeated-measures analysis of variance pair-wise comparisons and considered significant at P<.05.
Reproducibility and Responsiveness of Maximal Strength Measurements From the LA and MA Ankle Dorsiflexor Muscles at Baseline Over 3 Time Points (Test, 1-Day Retest, 1-Week Retest)a
↵a LA=less-affected limb, MA=more-affected limb, PM=peak moment (in newton-meters), MW=maximal work (in joules), ICC=intraclass correlation coefficient, CI=confidence interval, CV=coefficient of variation, SRDi=individual smallest real difference, SRDi%=individual smallest real difference (percentage). SRDi absolute values follow the same unit of measurement of the relative outcome measure.
Supplementary Data
eTables and eFigure
Files in this Data Supplement:
- eTables and eFigure (PDF) (406 KB) -
This PDF contains the following supplements:
- eFigure Effects of 6-week unilateral resistance training on the maximal work (MW) recorded from both the trained less-affected (LA) and untrained more-affected (MA) ankle dorsiflexors
- eTable 1. Changes and Responsiveness of the Clinical and Functional Outcomes as Determined by Repeated-Measures ANOVA
- eTable 2. Individual-Level Pretest-Posttest Changes in Strength of the Less-Affected Trained Ankle Dorsiflexor Muscles as Determined by the 2-Standard Deviations Method
- eTable 3. Clinical Relevance and Responsiveness of Changes in Strength After 3 and 6 Weeks of Resistance Training and at the 12-Week Follow-up
- eTable 4. Individual-Level Pretest-Posttest Changes in Strength of the Less-Affected Trained and More-Affected Untrained Ankle Dorsiflexor Muscles as Determined by the Smallest Real Difference Analysis
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