Eccentric resistance training with neurological conditions: A meta analysis

Abstract

Background: People with neurological conditions are exposed to muscle wasting resulting in reduced strength and endurance. Both deficiencies negatively impact gait and balance, each of which can be benefited by strengthening exercises. Unfortunately, people with neurological conditions often do not have the ability to perform traditional weight training as their endurance and strength fail to meet the minimum threshold for improvement. An alternative to traditional, full range of motion lifting is eccentric resistance training (ERT).

Research question: The current systematic review and meta-analysis sought to evaluate the efficacy of ERT against conventional therapeutic modalities or weightlifting on walking speed, Timed Up and Go (TUG), and maximum voluntary isometric contraction (MVIC) in individuals with neurological conditions.

Methods: Web of Science, PubMed, and Academic Search Complete were searched until September 1, 2020, followed by a manual search on December 3, 2021. Publications were included if they were peer reviewed, available in English, consisted of a pre-specified neurological disorder, involved human subjects, had an eccentric and "traditional" therapy; and reported at least one of the outcome measures at both pre- and post-intervention.

Results: Thirteen studies of human subjects (n = 297) and 47 standardized mean differences (SMD) were included in the multilevel model analysis. The analysis revealed a small, albeit non-significant effect on performance (TUG, MVIC, walking speed) when comparing traditional therapies and ERT (SMD: 0.136; 96; 95 % CI: -0.0002, 0.050).

Significance: There appears to be no difference between ERT and traditional therapy or weightlifting on measured outcomes. In this way, ERT is as effective as traditional therapeutics and full range of motion weightlifting to improve movement in clinical populations. Practitioners working with populations with neurological conditions may consider supplementing or replacing traditional strengthening activities with ERT as clients can complete greater volumes of work with lower metabolic demand.

Keywords: Clinical populations; Negative work; Neurological; Resistance training.