Strength training for partially paralysed muscles in people with recent spinal cord injury: a within-participant randomised controlled trial
Study design: Within-participant randomised controlled trial. Objectives: To determine whether strength training combined with usual care increases strength in partially paralysed muscles of people with recent spinal cord injury (SCI) more than usual care alone. Settings: SCI units in Australia and...
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| Veröffentlicht in: | Spinal cord 2017-05, Vol.55 (5), p.460-465 |
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| creator | Bye, E A Harvey, L A Gambhir, A Kataria, C Glinsky, J V Bowden, J L Malik, N Tranter, K E Lam, C P White, J S Gollan, E J Arora, M Gandevia, S C |
| description | Study design:
Within-participant randomised controlled trial.
Objectives:
To determine whether strength training combined with usual care increases strength in partially paralysed muscles of people with recent spinal cord injury (SCI) more than usual care alone.
Settings:
SCI units in Australia and India.
Methods:
Thirty people with recent SCI undergoing inpatient rehabilitation participated in this 12-week trial. One of the following muscle groups was selected as the target muscle group for each participant: the elbow flexors, elbow extensors, knee flexors or knee extensors. The target muscle on one side of the body was randomly allocated to the experimental group and the same muscle on the other side of the body was allocated to the control group. Strength training was administered to the experimental muscle but not to the control muscle. Participants were assessed at baseline and 12 weeks later. The primary outcome was maximal isometric muscle strength, and the secondary outcomes were spasticity, fatigue and participants’ perception of function and strength.
Results:
There were no dropouts, and participants received 98% of the training sessions. The mean (95% confidence interval (CI)) between-group difference for isometric strength was 4.3 Nm (1.9–6.8) with a clinically meaningful treatment effect of 2.7 Nm. The mean (95% CI) between-group difference for spasticity was 0.03/5 points (−0.25 to 0.32).
Conclusion:
Strength training increases strength in partially paralysed muscles of people with recent SCI, although it is not clear whether the size of the treatment effect is clinically meaningful. Strength training has no deleterious effects on spasticity. |
| doi_str_mv | 10.1038/sc.2016.162 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1901744296</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1846370249</sourcerecordid><originalsourceid>FETCH-LOGICAL-c424t-788715e1f6212a0c2807a3ee4feacff69d2c39b2dc981470d3d19c6ec3406c723</originalsourceid><addsrcrecordid>eNqFkUFrFDEYhoMotl09eZeAF0FnTb5kMxNvUtQKhR6q5yHNfLNmySZjkqHsf_BHm-lWkSJ4ygt58n7hewh5wdmaM9G9y3YNjKs1V_CInHLZqmajQD6uWShopNDihJzlvGOMaa67p-QEWg2gQJ2Sn9clYdiW77Qk44ILWzrGRCeTijPeH5Zk_CHjQPdzth4zdYFOGCeP9NbVdwkthkLz5ILx1MY0VGI3p8N7au4IF5q7OusmU8FkwhD3bmm0MZQUva-xpDruGXkyGp_x-f25It8-ffx6ftFcXn3-cv7hsrESZGnarmv5BvmogINhFjrWGoEoRzR2HJUewAp9A4PVXV0HG8TAtVVohWTKtiBW5PWxd0rxx4y59PU_Fr03AeOce64Zb6UErf6PdlKJloHUFX31AN3FOdWlLJTeALSi-lqRN0fKpphzwrGfktubdOg56xeffbb94rOvPiv98r5zvtnj8If9LbACb49Arldhi-mvof_o-wWzXKus</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1895227310</pqid></control><display><type>article</type><title>Strength training for partially paralysed muscles in people with recent spinal cord injury: a within-participant randomised controlled trial</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>SpringerLink Journals - AutoHoldings</source><creator>Bye, E A ; Harvey, L A ; Gambhir, A ; Kataria, C ; Glinsky, J V ; Bowden, J L ; Malik, N ; Tranter, K E ; Lam, C P ; White, J S ; Gollan, E J ; Arora, M ; Gandevia, S C</creator><creatorcontrib>Bye, E A ; Harvey, L A ; Gambhir, A ; Kataria, C ; Glinsky, J V ; Bowden, J L ; Malik, N ; Tranter, K E ; Lam, C P ; White, J S ; Gollan, E J ; Arora, M ; Gandevia, S C</creatorcontrib><description>Study design:
Within-participant randomised controlled trial.
Objectives:
To determine whether strength training combined with usual care increases strength in partially paralysed muscles of people with recent spinal cord injury (SCI) more than usual care alone.
Settings:
SCI units in Australia and India.
Methods:
Thirty people with recent SCI undergoing inpatient rehabilitation participated in this 12-week trial. One of the following muscle groups was selected as the target muscle group for each participant: the elbow flexors, elbow extensors, knee flexors or knee extensors. The target muscle on one side of the body was randomly allocated to the experimental group and the same muscle on the other side of the body was allocated to the control group. Strength training was administered to the experimental muscle but not to the control muscle. Participants were assessed at baseline and 12 weeks later. The primary outcome was maximal isometric muscle strength, and the secondary outcomes were spasticity, fatigue and participants’ perception of function and strength.
Results:
There were no dropouts, and participants received 98% of the training sessions. The mean (95% confidence interval (CI)) between-group difference for isometric strength was 4.3 Nm (1.9–6.8) with a clinically meaningful treatment effect of 2.7 Nm. The mean (95% CI) between-group difference for spasticity was 0.03/5 points (−0.25 to 0.32).
Conclusion:
Strength training increases strength in partially paralysed muscles of people with recent SCI, although it is not clear whether the size of the treatment effect is clinically meaningful. Strength training has no deleterious effects on spasticity.</description><identifier>ISSN: 1362-4393</identifier><identifier>EISSN: 1476-5624</identifier><identifier>DOI: 10.1038/sc.2016.162</identifier><identifier>PMID: 27922626</identifier><identifier>CODEN: SPCOFM</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/617/375/1824 ; Anatomy ; Biomedical and Life Sciences ; Biomedicine ; Electric Stimulation Therapy - methods ; Female ; Human Physiology ; Humans ; Male ; Muscle Spasticity - physiopathology ; Muscle Strength - physiology ; Muscle Weakness - physiopathology ; Muscle Weakness - rehabilitation ; Muscle, Skeletal - physiopathology ; Neurochemistry ; Neuropsychology ; Neurosciences ; original-article ; Paralysis - complications ; Paralysis - rehabilitation ; Resistance Training ; Spinal Cord Injuries - complications ; Spinal Cord Injuries - rehabilitation ; Treatment Outcome</subject><ispartof>Spinal cord, 2017-05, Vol.55 (5), p.460-465</ispartof><rights>International Spinal Cord Society 2017</rights><rights>Copyright Nature Publishing Group May 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-788715e1f6212a0c2807a3ee4feacff69d2c39b2dc981470d3d19c6ec3406c723</citedby><cites>FETCH-LOGICAL-c424t-788715e1f6212a0c2807a3ee4feacff69d2c39b2dc981470d3d19c6ec3406c723</cites><orcidid>0000-0003-1024-3682</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/sc.2016.162$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/sc.2016.162$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27922626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bye, E A</creatorcontrib><creatorcontrib>Harvey, L A</creatorcontrib><creatorcontrib>Gambhir, A</creatorcontrib><creatorcontrib>Kataria, C</creatorcontrib><creatorcontrib>Glinsky, J V</creatorcontrib><creatorcontrib>Bowden, J L</creatorcontrib><creatorcontrib>Malik, N</creatorcontrib><creatorcontrib>Tranter, K E</creatorcontrib><creatorcontrib>Lam, C P</creatorcontrib><creatorcontrib>White, J S</creatorcontrib><creatorcontrib>Gollan, E J</creatorcontrib><creatorcontrib>Arora, M</creatorcontrib><creatorcontrib>Gandevia, S C</creatorcontrib><title>Strength training for partially paralysed muscles in people with recent spinal cord injury: a within-participant randomised controlled trial</title><title>Spinal cord</title><addtitle>Spinal Cord</addtitle><addtitle>Spinal Cord</addtitle><description>Study design:
Within-participant randomised controlled trial.
Objectives:
To determine whether strength training combined with usual care increases strength in partially paralysed muscles of people with recent spinal cord injury (SCI) more than usual care alone.
Settings:
SCI units in Australia and India.
Methods:
Thirty people with recent SCI undergoing inpatient rehabilitation participated in this 12-week trial. One of the following muscle groups was selected as the target muscle group for each participant: the elbow flexors, elbow extensors, knee flexors or knee extensors. The target muscle on one side of the body was randomly allocated to the experimental group and the same muscle on the other side of the body was allocated to the control group. Strength training was administered to the experimental muscle but not to the control muscle. Participants were assessed at baseline and 12 weeks later. The primary outcome was maximal isometric muscle strength, and the secondary outcomes were spasticity, fatigue and participants’ perception of function and strength.
Results:
There were no dropouts, and participants received 98% of the training sessions. The mean (95% confidence interval (CI)) between-group difference for isometric strength was 4.3 Nm (1.9–6.8) with a clinically meaningful treatment effect of 2.7 Nm. The mean (95% CI) between-group difference for spasticity was 0.03/5 points (−0.25 to 0.32).
Conclusion:
Strength training increases strength in partially paralysed muscles of people with recent SCI, although it is not clear whether the size of the treatment effect is clinically meaningful. Strength training has no deleterious effects on spasticity.</description><subject>692/617/375/1824</subject><subject>Anatomy</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Electric Stimulation Therapy - methods</subject><subject>Female</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Muscle Spasticity - physiopathology</subject><subject>Muscle Strength - physiology</subject><subject>Muscle Weakness - physiopathology</subject><subject>Muscle Weakness - rehabilitation</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Neurochemistry</subject><subject>Neuropsychology</subject><subject>Neurosciences</subject><subject>original-article</subject><subject>Paralysis - complications</subject><subject>Paralysis - rehabilitation</subject><subject>Resistance Training</subject><subject>Spinal Cord Injuries - complications</subject><subject>Spinal Cord Injuries - rehabilitation</subject><subject>Treatment Outcome</subject><issn>1362-4393</issn><issn>1476-5624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkUFrFDEYhoMotl09eZeAF0FnTb5kMxNvUtQKhR6q5yHNfLNmySZjkqHsf_BHm-lWkSJ4ygt58n7hewh5wdmaM9G9y3YNjKs1V_CInHLZqmajQD6uWShopNDihJzlvGOMaa67p-QEWg2gQJ2Sn9clYdiW77Qk44ILWzrGRCeTijPeH5Zk_CHjQPdzth4zdYFOGCeP9NbVdwkthkLz5ILx1MY0VGI3p8N7au4IF5q7OusmU8FkwhD3bmm0MZQUva-xpDruGXkyGp_x-f25It8-ffx6ftFcXn3-cv7hsrESZGnarmv5BvmogINhFjrWGoEoRzR2HJUewAp9A4PVXV0HG8TAtVVohWTKtiBW5PWxd0rxx4y59PU_Fr03AeOce64Zb6UErf6PdlKJloHUFX31AN3FOdWlLJTeALSi-lqRN0fKpphzwrGfktubdOg56xeffbb94rOvPiv98r5zvtnj8If9LbACb49Arldhi-mvof_o-wWzXKus</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Bye, E A</creator><creator>Harvey, L A</creator><creator>Gambhir, A</creator><creator>Kataria, C</creator><creator>Glinsky, J V</creator><creator>Bowden, J L</creator><creator>Malik, N</creator><creator>Tranter, K E</creator><creator>Lam, C P</creator><creator>White, J S</creator><creator>Gollan, E J</creator><creator>Arora, M</creator><creator>Gandevia, S C</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1024-3682</orcidid></search><sort><creationdate>20170501</creationdate><title>Strength training for partially paralysed muscles in people with recent spinal cord injury: a within-participant randomised controlled trial</title><author>Bye, E A ; Harvey, L A ; Gambhir, A ; Kataria, C ; Glinsky, J V ; Bowden, J L ; Malik, N ; Tranter, K E ; Lam, C P ; White, J S ; Gollan, E J ; Arora, M ; Gandevia, S C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-788715e1f6212a0c2807a3ee4feacff69d2c39b2dc981470d3d19c6ec3406c723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>692/617/375/1824</topic><topic>Anatomy</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Electric Stimulation Therapy - methods</topic><topic>Female</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Muscle Spasticity - physiopathology</topic><topic>Muscle Strength - physiology</topic><topic>Muscle Weakness - physiopathology</topic><topic>Muscle Weakness - rehabilitation</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Neurochemistry</topic><topic>Neuropsychology</topic><topic>Neurosciences</topic><topic>original-article</topic><topic>Paralysis - complications</topic><topic>Paralysis - rehabilitation</topic><topic>Resistance Training</topic><topic>Spinal Cord Injuries - complications</topic><topic>Spinal Cord Injuries - rehabilitation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bye, E A</creatorcontrib><creatorcontrib>Harvey, L A</creatorcontrib><creatorcontrib>Gambhir, A</creatorcontrib><creatorcontrib>Kataria, C</creatorcontrib><creatorcontrib>Glinsky, J V</creatorcontrib><creatorcontrib>Bowden, J L</creatorcontrib><creatorcontrib>Malik, N</creatorcontrib><creatorcontrib>Tranter, K E</creatorcontrib><creatorcontrib>Lam, C P</creatorcontrib><creatorcontrib>White, J S</creatorcontrib><creatorcontrib>Gollan, E J</creatorcontrib><creatorcontrib>Arora, M</creatorcontrib><creatorcontrib>Gandevia, S C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Spinal cord</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bye, E A</au><au>Harvey, L A</au><au>Gambhir, A</au><au>Kataria, C</au><au>Glinsky, J V</au><au>Bowden, J L</au><au>Malik, N</au><au>Tranter, K E</au><au>Lam, C P</au><au>White, J S</au><au>Gollan, E J</au><au>Arora, M</au><au>Gandevia, S C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Strength training for partially paralysed muscles in people with recent spinal cord injury: a within-participant randomised controlled trial</atitle><jtitle>Spinal cord</jtitle><stitle>Spinal Cord</stitle><addtitle>Spinal Cord</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>55</volume><issue>5</issue><spage>460</spage><epage>465</epage><pages>460-465</pages><issn>1362-4393</issn><eissn>1476-5624</eissn><coden>SPCOFM</coden><abstract>Study design:
Within-participant randomised controlled trial.
Objectives:
To determine whether strength training combined with usual care increases strength in partially paralysed muscles of people with recent spinal cord injury (SCI) more than usual care alone.
Settings:
SCI units in Australia and India.
Methods:
Thirty people with recent SCI undergoing inpatient rehabilitation participated in this 12-week trial. One of the following muscle groups was selected as the target muscle group for each participant: the elbow flexors, elbow extensors, knee flexors or knee extensors. The target muscle on one side of the body was randomly allocated to the experimental group and the same muscle on the other side of the body was allocated to the control group. Strength training was administered to the experimental muscle but not to the control muscle. Participants were assessed at baseline and 12 weeks later. The primary outcome was maximal isometric muscle strength, and the secondary outcomes were spasticity, fatigue and participants’ perception of function and strength.
Results:
There were no dropouts, and participants received 98% of the training sessions. The mean (95% confidence interval (CI)) between-group difference for isometric strength was 4.3 Nm (1.9–6.8) with a clinically meaningful treatment effect of 2.7 Nm. The mean (95% CI) between-group difference for spasticity was 0.03/5 points (−0.25 to 0.32).
Conclusion:
Strength training increases strength in partially paralysed muscles of people with recent SCI, although it is not clear whether the size of the treatment effect is clinically meaningful. Strength training has no deleterious effects on spasticity.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>27922626</pmid><doi>10.1038/sc.2016.162</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-1024-3682</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Spinal cord, 2017-05, Vol.55 (5), p.460-465 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SpringerLink Journals - AutoHoldings |
| subjects | 692/617/375/1824 Anatomy Biomedical and Life Sciences Biomedicine Electric Stimulation Therapy - methods Female Human Physiology Humans Male Muscle Spasticity - physiopathology Muscle Strength - physiology Muscle Weakness - physiopathology Muscle Weakness - rehabilitation Muscle, Skeletal - physiopathology Neurochemistry Neuropsychology Neurosciences original-article Paralysis - complications Paralysis - rehabilitation Resistance Training Spinal Cord Injuries - complications Spinal Cord Injuries - rehabilitation Treatment Outcome |
| title | Strength training for partially paralysed muscles in people with recent spinal cord injury: a within-participant randomised controlled trial |
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