ABSTRACT
Multiple sclerosis (MS) is an immune-mediated, neurodegenerative disease of white and gray matter in the central nervous system (CNS). There are many consequences of MS such as worsening disability, ambulation, symptomology, and quality of life (QoL). These consequences may be the direct result of damage and atrophy of CNS tissue, or may be brought about by other changes such as muscle weakness and associated changes in the skeletal muscle prole. Indeed, muscle weakness and altered skeletal muscle characteristics are common in MS1-6 and may be a consequence of the disease process itself,7 or a secondary effect of deconditioning caused by physical inactivity.8,9 We further note that markers of muscle weakness have been associated with ambulatory impairment, postural instability, fatigue, and poor cognitive performance in MS.2,10-12
Introduction ............................................................................................................ 103 Muscle Weakness in Multiple Sclerosis ................................................................. 104
Mechanisms of Muscle Weakness in Multiple Sclerosis .................................. 105 Resistance Training in Multiple Sclerosis.............................................................. 107
Progressive Resistance Training for Muscular Strength and the Skeletal Muscle Prole ................................................................................................... 107 Progressive Resistance Training for Mobility, Fatigue, and Quality of Life ................................................................................................................ 110
Prescription of Resistance Training in Persons with Multiple Sclerosis ............... 112 Limitations of the Literature .................................................................................. 113 Conclusions ............................................................................................................ 113 References .............................................................................................................. 114
Resistance training represents a strategy for preserving, maintaining, or improving skeletal muscle strength and morphological characteristics in persons with MS and may, in turn, have meaningful functional and symptomatic consequences. This chapter describes changes in skeletal muscle characteristics in persons with MS and provides a review of the potential benets of progressive resistance training (PRT) primarily with respect to adaptations in strength and the skeletal muscle prole, but secondarily with respect to mobility, fatigue, and QoL.
