Muscle fiber size increases following resistance training in multiple sclerosis

Abstract

Objective: To test the hypothesis that lower body progressive resistance training (PRT) leads to an increase of the muscle fiber cross-sectional area (CSA) and a shift in the proportion of fiber types in patients with multiple sclerosis (MS).

Methods: The present study was a two-arm, randomized controlled trial (RCT). Thirty-eight MS patients (Expanded Disability Status Scale (EDSS) 3—5.5) were randomized to a PRT group (Exercise, n = 19) or a control group (Control, n = 19). The Exercise group performed a biweekly 12-week lower body PRT program [five exercises progressing from 15RM (Repetition Maximum) towards 8RM], whereas the Control group maintained their usual daily activity level during the trial period. Muscle biopsies from vastus lateralis were taken before (pre) and after the trial (post). Thigh volume (TV) was estimated from anthropometric measurements. Isokinetic muscle strength of the knee extensors (KE) and flexors (KF) were evaluated at slow (90^°/s) and fast (180^°/s) angular velocities.

Results: In the Exercise group the mean CSA of all muscle fibers (7.9 ± 15.4% vs. -3.5 ± 9.0%, p = 0.03) and of type II muscle fibers (14.0 ± 19.4% vs. -2.6 ± 15.5%, p = 0.02) increased in comparison with the Control group. No changes occurred in the proportion of fiber types in the Exercise group. Neither was there any change in total TV. Isokinetic strength at KE180, KF90 and KF180 improved significantly after PRT when compared with the control group (10.2—21.3%, p ≤ 0.02).

Conclusions: We conclude that progressive resistance training induces a compensatory increase of muscle fiber size in patients with the central nervous system disorder, multiple sclerosis.

Keywords

exercise exercise therapy MS rehabilitation muscle strength strength training

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References

Kantarci OH Genetics and natural history of multiple sclerosis. Semin Neurol 2008; 28: 7-16.

Miller A. and Dishon S. Health-related Quality of Life in Multiple Sclerosis: The Impact of Disability, Gender and Employment Status. Qual Life Res 2006; 15: 259-271.

Savci S. , Inal-Ince D. , Arikan H. , et al. Six-minute walk distance as a measure of functional exercise capacity in multiple sclerosis. Disabil Rehabil 2005; 27: 1365-1371.

Thoumie P. and Mevellec E. Relation between walking speed and muscle strength is affected by somatosensory loss in multiple sclerosis. J Neurol Neurosurg Psychiatry 2002; 73: 313-315.

Schwid SR , Thornton CA , Pandya S. , et al. Quantitative assessment of motor fatigue and strength in MS . Neurology 1999; 53: 743-750.

Kent-Braun JA , Ng AV , Castro M. , et al. Strength, skeletal muscle composition, and enzyme activity in multiple sclerosis. J Appl Physiol 1997; 83: 1998-2004.

Garner DJ and Widrick JJ Cross-bridge mechanisms of muscle weakness in multiple sclerosis. Muscle Nerve 2003; 27: 456-464.

Carroll CC , Gallagher PM , Seidle ME and Trappe SW Skeletal muscle characteristics of people with multiple sclerosis. Arch Phys Med Rehabil 2005; 86: 224-229.

de-Haan A. , de Ruiter CJ , Der Woude LH and Jongen PJ Contractile properties and fatigue of quadriceps muscles in multiple sclerosis . Muscle Nerve 2000; 23: 1534-1541.

10.

Ng AV , Miller RG , Gelinas D. and Kent-Braun JA Functional relationships of central and peripheral muscle alterations in multiple sclerosis. Muscle Nerve 2004; 29: 843-852.

11.

Formica CA , Cosman F. , Nieves J. , Herbert J. and Lindsay R. Reduced bone mass and fat-free mass in women with multiple sclerosis: effects of ambulatory status and glucocorticoid Use. Calcif Tissue Int 1997; 61: 129-133.

12.

Lambert CP , Lee AR and Evans WJ Body composition in ambulatory women with multiple sclerosis. Arch Phys Med Rehabil 2002; 83: 1559-1561.

13.

Hortobagyi T. , Dempsey L. , Fraser D. , et al. Changes in muscle strength, muscle fibre size and myofibrillar gene expression after immobilization and retraining in humans. J Physiol 2000; 524: 293-304.

14.

Gallagher P. , Trappe S. , Harber M. , et al. Effects of 84-days of bedrest and resistance training on single muscle fibre myosin heavy chain distribution in human vastus lateralis and soleus muscles. Acta Physiol Scand 2005; 185: 61-69.

15.

Andersen JL , Gruschy-Knudsen T. , Sandri C. , Larsson L. and Schiaffino S. Bed rest increases the amount of mismatched fibers in human skeletal muscle. J Appl Physiol 1999; 86: 455-460.

16.

Karpatkin H. Multiple sclerosis and exercise - a review of the evidence. Int J MS Care 2006; 7: 36-41.

17.

Dalgas U. , Stenager E. and Ingemann-Hansen T. Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training. Mult Scler 2008; 14: 35-53.

18.

Dalgas U. , Stenager E. , Jakobsen J. , et al. Resistance training improves muscle strength and functional capacity in multiple sclerosis. Neurology 2009; 73: 1478-1484.

19.

Kraemer WJ , Deschenes MR and Fleck SJ Physiological adaptations to resistance exercise. Implications for athletic conditioning. Sports Med 1988; 6: 246-256.

20.

Linker R. , Gold R. and Luhder F. Function of neurotrophic factors beyond the nervous system: inflammation and autoimmune demyelination. Crit Rev Immunol 2009; 29: 43-68.

21.

Dalgas U. , Stenager E. , Jakobsen J. , et al. Fatigue, mood and quality of life improve in MS patients after progressive resistance training. Mult Scler 2010; 16: 480-490.

22.

McDonald WI , Compston A. , Edan G. , et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Ann Neurol 2001; 50: 121-127.

23.

Armstrong LE , Winant DM , Swasey PR , Seidle ME , Carter AL and Gehlsen G. Using isokinetic dynamometry to test ambulatory patients with multiple sclerosis. Phys Ther 1983; 63: 1274-1279.

24.

Basiotis PP , Welsh SO , Cronin FJ , Kelsay JL and Mertz W. Number of days of food intake records required to estimate individual and group nutrient intakes with defined confidence . J Nutr 1987; 117: 1638-1641.

25.

Durnin J. and Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 1974; 32: 77-97.

26.

Saltin B. and Grimby G. Physiological analysis of middle-aged and old former athletes. Comparison with still active athletes of the same ages. Circulation 1968; 38: 1104-1115.

27.

Alexander J. , Anderssen SA , Aro A. , et al. Nordic Nutrition Recommendations, 4th edition, NORD:13 (Denmark): 2004.

28.

Ingemann-Hansen T. and Halkjaer-Kristensen J. Lean and fat component of the human thigh. The effects of immobilization in plaster and subsequent physical training. Scand J Rehabil Med 1977 ; 9: 67-72.

29.

Brooke MH and Kaiser KK

Muscle fiber types: how many and what kind?

Arch Neurol 1970; 23: 369-379.

30.

Qu Z. , Andersen JL and Zhou S. Visualisation of capillaries in human skeletal muscle. Histochem Cell Biol 1997; 107: 169-174.

31.

Andersen JL and Aagaard P. Myosin heavy chain IIX overshoot in human skeletal muscle. Muscle Nerve 2000; 23: 1095-1104.

32.

DeBolt LS and McCubbin JA The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. Arch Phys Med Rehabil 2004; 85: 290-297.

33.

White LJ , McCoy SC , Castellano V. , et al. Resistance training improves strength and functional capacity in persons with multiple sclerosis. Mult Scler 2004; 10: 668-674.

34.

Kasser S. and McCubbin JA Effects of progressive resistance exercise on muscular strength in adults with multiple sclerosis. Med Sci Sports Exerc 1996; 28: S143.

35.

Staron RS , Hagerman FC , Hikida RS , et al. Fiber type composition of the vastus lateralis muscle of young men and women. J Histochem Cytochem 2000; 48: 623-629.

36.

Lexell J. , Taylor CC and Sjostrom M. What is the cause of the ageing atrophy? Total number, size and proportion of different fiber types studied in whole vastus lateralis muscle from 15- to 83-year-old men. J Neurol Sci 1988; 84: 275-294.

37.

Hakkinen K. , Komi PV and Tesch PA Effects of combined concentric and eccentric strength training and detraining on force-time, muscle fibre, and metabolic characteristics of leg extensor muscles. Scand J Sports Sci 1981; 3: 50-58.

38.

Henneman E. , Somjen G. and Carpenter D. Functional significance of cell size in spinal motoneurons. J Neurophysiol 1965; 28: 560-580.

39.

Folland JP and Williams AG The adaptations to strength training: morphological and neurological contributions to increased strength. Sports Med 2007; 37: 145-168.

40.

Staron RS , Malicky ES , Leonardi MJ , Falkel JE , Hagerman FC and Dudley GA Muscle hypertrophy and fast fiber type conversions in heavy resistance-trained women. Eur J Appl Physiol Occup Physiol 1990 ; 60: 71-79.

41.

Dons B. , Bollerup K. , Bonde-Petersen F. and Hancke S. The effect of weight-lifting exercise related to muscle fiber composition and muscle cross-sectional area in humans. Eur J Appl Physiol Occup Physiol 1979; 40: 95-106.

42.

Houston ME , Froese EA , Valeriote SP , Green HJ and Ranney DA Muscle performance, morphology and metabolic capacity during strength training and detraining: a one leg model. Eur J Appl Physiol Occup Physiol 1983; 51: 25-35.

43.

MacDougall JD , Elder GC , Sale DG , Moroz JR and Sutton JR Effects of strength training and immobilization on human muscle fibres. Eur J Appl Physiol Occup Physiol 1980; 43: 25-34.

44.

Stuifbergen AK Physical activity and perceived health status in persons with multiple sclerosis. J Neurosci Nurs 1997; 29: 238-243.

45.

Hakkinen K. , Newton RU , Gordon SE , et al. Changes in muscle morphology, electromyographic activity, and force production characteristics during progressive strength training in young and older men. J Gerontol A Biol Sci Med Sci 1998; 53: B415-B423.

46.

Hikida RS , Staron RS , Hagerman FC , et al. Effects of high-intensity resistance training on untrained older men. II. Muscle fiber characteristics and nucleo-cytoplasmic relationships . J Gerontol A Biol Sci Med Sci 2000; 55: B347-B354.

47.

Frontera WR , Meredith CN , O’Reilly KP and Evans WJ Strength training and determinants of VO2max in older men. J Appl Physiol 1990; 68: 329-333.

48.

Hakkinen K. , Pakarinen A. , Kraemer WJ , Hakkinen A. , Valkeinen H. and Alen M. Selective muscle hypertrophy, changes in EMG and force, and serum hormones during strength training in older women. J Appl Physiol 2001; 91: 569-580.

49.

Kraemer WJ , Patton JF , Gordon SE , et al. Compatibility of high-intensity strength and endurance training on hormonal and skeletal muscle adaptations. J Appl Physiol 1995; 78: 976-989.

50.

Elder GC , Bradbury K. and Roberts R. Variability of fiber type distributions within human muscles. J Appl Physiol 1982; 53: 1473-1480.

51.

Lexell J. , Henriksson-Larsen K. and Sjostrom M. Distribution of different fibre types in human skeletal muscles. 2. A study of cross-sections of whole m. vastus lateralis. Acta Physiol Scand 1983; 117: 115-122.

52.

Halkjaer-Kristensen J. and Ingemann-Hansen T. Variations in single fibre areas and fibre composition in needle biopsies from the human quadriceps muscle. Scand J Clin Lab Invest 1981; 41: 391-395.

53.

Lexell J. , Taylor C. and Sjostrom M. Analysis of sampling errors in biopsy techniques using data from whole muscle cross sections. J Appl Physiol 1985; 59: 1228-1235.