Effects of the Cross-Training in Patients With Multiple Sclerosis
Condition: Multiple Sclerosis; Weakness; Fatigue
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Interventional

Summary: 
      The purpose of this study is to determine whether, in patients with multiple sclerosis
      presenting with marked asymmetry of strength, training the less-affected limb with a
      Cross-Training approach may induce a meaningful transfer of strength with neurophysiological,
      functional and clinical correlates, to the contralateral, more-impaired limb.
    

Detailed description: 
      Muscle weakness is a major disability that is responsible for deeply reducing the overall
      quality of life (QoL) of patients with Multiple Sclerosis (MS). Research has shown that
      strength training (ST) has a significant positive effect on the performance of daily living
      activities in people with MS, resulting in an increased QoL. Several ST methods are currently
      employed for reducing strength impairment in MS but no one regimen has been portrayed as
      superior to others. When strength impairment is prominently lateralized to one limb, training
      is commonly addressed to the weaker side in order to balance the deficit. However, such ST
      may not always be applicable to a severely weakened limb that is too compromised to sustain
      it. For these selected patients we hypothesize that training the less affected limb with a
      Cross Training (CT) approach may overcome the problem, also avoiding patients' frustration
      and potential withdrawals from rehabilitation programs.

      Aim of this project is to investigate and compare in two groups of selected MS patients, with
      a marked asymmetry of strength, the effects induced on dynamometric, neurophysiological,
      functional and clinical outcomes by a CT of the less-impaired leg (CT group) compared to a ST
      of the more-impaired leg (ST group). In order to make comparisons with a population which is
      not exposed to the condition MS, a third group composed of healthy subjects will also be
      included in the study.

      The research plan will be articulated in 5 phases (recruitment, baseline assessment, 6
      week-intervention phase, post-intervention assessment and follow up at 12 weeks).
    

Intervention name(s): Cross-Training healthy subjects; Cross-Training multiple sclerosis; Standard-training multiple sclerosis
Intervention type(s): Other; Other; Other
Intervention description(s): The phase of intervention will consist of a 6-week cross-training of the stronger limb employing an isokinetic contraction regimen at maximal intensity.; The phase of intervention will consist of a 6-week cross-training of the less-impaired limb employing an isokinetic contraction regimen at maximal intensity.; The phase of intervention will consist of a 6-week standard strength training of the more-impaired limb employing an isokinetic contraction regimen performed at maximal intensity.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Resistance training/methods; contralateral strength training; ipsilateral strength training; Isokinetic contraction; Adaptation, Physiological/physiology; Electromyography/methods; Transcranial Magnetic Stimulation/methods; Evoked Potentials, Motor