| Strength Training For People With MS |
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Strength is defined as the quality of being strong or powerful as it relates to
muscular activity. Muscle strength is needed to perform daily activities.
Weakness can decrease function. People with MS often report weakness or lack
of strength as a problem. Strength can be affected by fatigue, spasticity and
limitations in range of motion. Strength training is designed to improve
muscle power, bone strength (decrease the risk of osteoporosis), physical
capacity for daily activities and prevent injury. Additional benefits for
people with MS may be increased endurance (delaying the onset of muscle fatigue),
increased strength which can help with posture, balance and movement.
The primary goal of strength training for people with MS is to improve
strength and endurance due to deconditioning.
The first step in determining an appropriate strength training program is
identification of the muscle weakness. Your physician, physical therapist,
occupational therapist and/or exercise physiologist can measure muscle
strength (and weakness) to help guide your strength training program.
Testing for muscle strength is done through different means. The most common
method of measuring muscle strength is the manual muscle test (MMT).
The MMT consists of moving a body part through range of motion with resistance applied.
Muscles are rated on a 0-5 scale with 0 being no muscle contraction and 5 being
full movement with normal resistance.
Other means of measuring muscle strength include hand held dynamometers,
isotonic measures and isokinetic measures. Hand held dynamometers provide
objective measures of an isometric contraction (contraction of a muscle
without movement). Isotonic measures include measurement of the amount of
weight which can be lifted in a set number of repetitions. For example,
a one repetition maximum (1RM) is the total amount of weight one can lift
for one repetition, while a 10 RM is the amount one can lift for 10 repetitions.
Isokinetic measures are measures taken when the resistance is variable
throughout the range of motion. These measures require the use of specialized equipment.
The graphs produced provide information on muscle strength and endurance.
Once muscle strength has been evaluated, a strength training program can be established.
There are different types of resistance which can be used to strengthen specific
muscles or muscle groups. Free weights, weight machines, elastic tubing, water
(pool exercises) and manual resistance are common modes of strength training.
For individuals who have significant difficulty, the use of gravity as a form
of resistance can be effective. The amount of resistance is determined by the
strength assessment and the goals of the strength training program.
The frequency of the strength training program is also dependent upon the goals
of the program. It is important to work within symptoms, particularly fatigue.
The usual recommendation for strength training is 2-3 days per week.
It is important to allow rest in between strength training to allow for adequate
muscle recovery. If training on successive days, it is important to alternate
muscles or muscle groups unless otherwise instructed by your physician,
physical/occupational therapist or exercise physiologist.
Some tips for success in your strength training program are:
- Identify the goals of your strength training program; consult a physician,
physical therapist, occupational therapist or exercise physiologist for assistance
and identification of appropriate strength training exercises.
- Perform exercises through a full range of motion; this will help reduce the risk
of injury to muscles, tendons and joints.
- It is not necessary to work your muscles to the point of fatigue.
- Don’t be impatient. Allow yourself adequate time for recovery between sets of
exercises if doing more than one set of exercises per muscle or muscle group.
- Be practical. Plan your strength program so you don’t fatigue yourself so you
can’t do the things you enjoy.
Strengthening exercises are important as part of a comprehensive exercise program.
It is important to identify appropriate exercises before initiating your program.
Your healthcare team can be helpful in establishing an individualized
program to meet your needs.
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| - reprinted with permision from- The Heuga Center. |
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