作者谨感激地承认Rhul酒店Marasigan和所有的研究参与者。这次演习插图是由Tziporah汤普森提供的。

注:约翰·霍普金斯大学医学院和肯尼迪克里格研究所的机构审查委员会批准了这项工作。所有与会者都参与之前提供书面同意。 1.培训<ol><li>确保教师是之前启动该协议充分的培训，在使用手持式测力和运动的细节具体情况。 注:测试个人的组合具有不同强度等级，以确保竞争力和一致性下面的测试和演习的细节在第6和8.2在细节的。 </li></ol> 2.选择位置和所需设备的习题课<ol><li>招2-5个人做练习在授权的时间。 </li><li>确保有空间的加权底座，能够安全地支持一个人在说谎和掌握扎实的地面上，有靠墙一个长边。确保有地板垂直于至少2.5米和1米上趾板的短侧基座腿的长边意图间隙在地面上。 </li><li>确保有一个与以下设备可用足够的空间:两把椅子有至少18英寸从地面的座椅高度，并且没有轮或武器; 2填充"瑜珈"垫;一个可调节高度的工作台（约90厘米×30厘米×45〜60厘米）。请确保有足够的空间供人们在房间允许设备安全地移动（步行者;手杖）在必要时使用。需要更多的空间用于具有越障学员群体。 </li></ol> 3.阻力带<ol><li>获得自商业来源阻力带（见材料和​​设备列表）。 注:不同的颜色带代表不同数量的阻力。请检查包​​装是否购买，以确定阻力大小的条带。在这个学习的榜样，五无乳胶带响荷兰国际集团13至40牛顿的力（N），在100％伸长率，使用（具体:一层:13，两级:20，三级:27，4级:33，5级:40）。使用附加电阻管材更强的参与者有六个级别的力量:45 N，七级67 N和八级:89 N. </li><li>使用160厘米（厘米）每个波段的颜色长度。马克20厘米部分每个相应的频段。结带在约一个环形塑料拉链领带每个20厘米关口。使用此个性化的阻力强度。这样做的阻力带的每个级别/颜色。 </li><li>使用8厘米登山扣，结合各阻力带的一个水平，使至少4套。这将是对个体化的电阻在每个站重要。 注:登山扣和拉链关系需要有一个最低一斤抗拉强度以抵抗张力充分，确保安全性能。 225ñ扎带和667ñ实力铁锁已经被可靠地用于本成立。要ANCH或频带，以下可能需要:绳（长度将依赖于选择的其它设备）;方&#39;S&#39;钩;门锚。 </li></ol> 4.参与者招募<ol><li>通过口，传单，医生或朋友引荐，MS通讯，MS支持组，和网站文字招收成人MS。 </li><li>确保与MS个体是:稳定他们的药物，并一直为〜6个月，病情稳定，能够独立地按照2步的方向，有在臀部，膝盖，脚踝，和最小的疼痛功能的被动运动范围。 </li></ol> 5.电话筛选注:这是必不可少的解释有兴趣的人有什么参与要求和评估参与者的资格。 <ol><li>草案可以遵循通过使呼叫所以没有细节被错过的人的文档。 注:在电话筛选，一定要包括人口统计学资料显示，入选和排除标准，残疾级别和锻炼计划的结构进行审查（ 即天，时间长度）以及如何从锻炼计划的期望。 </li><li>联系感兴趣的参与者和调度电话筛选。 注:如果是一个人的健康安全地参加一个锻炼计划的问题时，有与会者问他或她的医生为笔记批准的锻炼计划。 </li></ol> 6.参加预测试注:在开始性培训项目开展前2周内预测试。 <ol><li>安排每个参与者为初始测试会话（试验前）在一天中的参与者优选时间，和记录时间，使所有的测试会话可以是在此优选时间。 </li><li>获得每个参与者的参与事先的书面知情同意书。 </li><li>获得强度测量值的臀部屈肌用测力计持有一只手伸髋关节和髋关节外展肌，以评估基准实力地位，利用休息的考验。确保测试仪压倒参与者的肌肉力量，所描述的Bohannon 等。 注:间隔测试完成后，参与者不再能够保持最大的阻力和肢体开始移动了首发位置。对于所有的测试确保参与者不使用他们的手臂扶住或准备迎接20。 <ol><li>执行交替身体侧的所有测试和重复内获得45 N对方两个一致的措施，每边。请参与者保持每个姿势4-5秒，极大的努力。记录每项措施和执行措施的测试。平均两个措施，每边的效果，请使用。 注:在每一个肌肉群之前，每个测试解释到与会者的过程。 </li><li>对于髋关节屈曲，指导PArticipant仰卧在垫子上，双腿伸展，全身放松，头搁在枕头上。指导参与者弯曲一个膝盖和臀部，并保持臀部成90度角。 <ol><li>广场上的股骨远端的测功机。指导参与者膝盖拉往鼻子不放的强烈越好。膝盖不能移动横向或这一运动过程中内侧。在参加者的脚趾的方向拉测功机缓慢而均匀地</li></ol></li><li>对于髋关节伸展，指导参与者趴在底座上，双腿伸展和身体放松。提供胸下一个枕头如果参与者是不舒服的躺在完全放平或限制了髋关节活动范围的扩展。指导参与者弯曲一侧膝盖屈曲成90度，并保持。 <ol><li>广场上的股骨远端的测功机。指导用户使用臀部抬脚离垫子参与者，持有和不扭曲。推测力计向下在米的方向在。 注:教师可以休息的手不持有测功机在垫子上，以确保当测功机正在使用的腿部没有达到在垫子上。 </li></ol></li><li>对于髋关节外展，指示参与者说谎侧卧与肩，背，和臀部靠在墙上的垫子。提供一个枕头如果需要参与者休息。可选要求参与者休息他们的头在底部手臂或手。解释到参与者弯曲底部腿膝盖，并用脚后跟接触壁和脚趾指向稍微向上延伸的顶部的腿。指导参与者保持上面的腿伸直脚跟靠在墙上，并取消他或她的腿高达约45度，并保持。 <ol><li>广场上的腿（ 即股骨远端）侧面的测功机和下推。 </li></ol></li></ol></li></ol> 7.计划注:指示在1.产品的参与者在第7和第8 7.1详细的储器材料的演习细节 - 7.8需要在第一次会议上解释，并根据需要审查。指示行使一次一个和不多于三个为每天最佳参与者训练。指导一对单尽可能最佳的监督和性能。预计1-2周的高机能个人学习运动性能的基础知识，2-3周越障人士。预计需要监督和帮助，以减少在程序的过程中。然而，教官将继续根据需要在整个程序中的阻力增大往往导致增加的努力和更多的困难，参加对齐，以提供直接观察和提示指令。 <ol><li>指示的原则和该程序的目标的参与者。 <ol><li>指导该计划的主要目的是加强对重点腿部肌肉最大限度地行走参与者。 </li><li>指导对离体加强肌肉的重要性的参与者。加强一个孤立的肌肉看起来容易，但定位，控制运动，并增加阻力作出努力高。如果肌肉不能孤立地加强，强者会更强，弱者会更弱。 </li><li>指导，功能训练演习的目的是将孤立的肌肉加强入全身运动的参与者。强调正确对准是必要的最佳肌肉性能。说明该功能锻炼展示的方式来练习适用于日常活动的参与者。 </li></ol></li><li>指导对参与者的方案预期的参与者。 <ol><li>提供团体运动的参与每周三次12周，共36届。包括三个工作日的会议之间的休息日。例如，周一，周二，周四格式都是适宜即</li><li>要求参与者在14周内完成至少33组会议。 <ol><li>提供每月补会议，使与会者能够实现这一目标。 </li></ol></li><li>提供并要求参与者完成三个练习每个周末一天的家庭计划。 </li></ol></li><li>指导中的安全性和时效性的小组练习设置的与会者。 注:包括在指令如下:重要的是开始时间和结束时间为一组。当到达早期等待教练开始。当迟到也可能无法完成当日所有的练习。注意时间是必要的，因为空间的可用性。尊重安全和礼貌的中心位置。 </li><li>指导在注意参与者的安全。 <ol><li>通过参加到"设置"的运动器材和其他人在R移动时，在房间里确保参与者谨慎使用<html> OOM。请参与者使用，必要时，一行走装置走动的室，以确保该组的安全性。强调的是教师能够专注于练习类，而不需要中断会议，以解决出现由于注意力不集中的个人安全问题的重要性。 </li></ol></li><li>通知的健身器材的使用与维护的参与者 注:在适当情况下，导师设置并在每次下课后取下设备。 <ol><li>根据医院的指导方针确保辅导员的清洁设备。指示参与者使用个人毛巾覆盖垫子，以保持设备和用于控制感染的完整性。 </li></ol></li><li>指导锻炼站格式的参与者<ol><li>确保教师分配起点站和订餐站。请参阅参与者使用每周记录表的白色柱（trengthtraininginMS_121415.pdf"目标="_空白"&gt;见附录），以表示当天具体的练习。 </li><li>指导参与者及时性是必不可少的，每个人都打通所有的练习在每届会议。指导参与者参加的指示两腿之间和车站之间切换。鼓励参与者寻求帮助与设置为需要</li></ol></li><li>指导学员在日常格式<ol><li>为参加者提供一个登录表为教师监测遵守考勤。 </li><li>确保教师后与下面的列表，以供参考的标志:在（日期和首字母缩写）标志;热身教练;获取剪贴板和运动包;穿戴合适的踝带或大腿表带;移动到第一站;更改电台指示;输入努力和每个运动后记录表重复;完成所有的强化和功能锻炼;请把原木，带和笔放回包里，离开与教练在会议结束（ <a href="https://jove.unicartagenaproxy.elogim.com/files/ftp_upload/53449/AppendixstrengthtraininginMS_121415.pdf" target="_blank">见附录锻炼日志</a> ）。 </li></ol></li></ol> 8.一般注意事项<ol><li>指导学员在日常的每一个练习: <ol><li>请参阅锻炼日志适当的表带和钩的位置。执行一条腿，回到开始姿势前保持3-5秒，结束范围。慢慢地，具有良好的对准执行每一个动作。两套重复与套之间的60秒休息执行每个运动。 </li><li>参阅参与者的日志的第一页为每组重复次数。重复练习的另一边。指导参与者所指示的每个练习移动到下一个所提供的运动日志之前（见6.19说明）来记录性能。 </li><li>提供足够的培训和监督的具体的练习。指示行使一次一个和不多于三个为每天最佳参与者训练。指导一对单尽可能最佳的监督和性能。 </li><li>对于更高的功能个人预计用1-2周的学习运动性能的基础知识和周1-3越障人士。 </li><li>为减少在节目的过程监督和援助金额为参与者变得更加独立。然而，提供直接的观察，并根据需要在整个程序作为增加性往往会导致增加的努力和更多的困难，参加对齐插入磁。 </li></ol></li><li>热身运动<ol><li>选择最合适的热身组在每届会议。 注:推荐热身选项包括:向前走或游行;向后走;回避或跳过每个30米。有所不同，需要根据组的能力。 </li></ol></li><li>髋关节屈曲<ol><li>指导参与者仰卧与双髋伸直。指导参与者慢慢抬起向胸部靠近，以髋关节屈曲的结束范围单膝跪地，保持膝盖靠近中线。指导参与者小腿与控制起始位置。请参与者收紧自己的腹部肌肉，如果有必要保持骨盆稳定。 </li><li>对于较弱的人，指导参与者进行这种侧卧与支持低板凳摆在参与者面前的顶边。 </li></ol></li><li>髋关节外展<ol><li>指导参与者说谎侧卧与底边略弯曲，上面的腿伸直。指导参与者解除了上面的腿向天花板，保持腿与躯干和朝向正前方或稍膝线转升向天花板。指导参与者降低腿起始位置。使用墙上的参与者身后，以确保守lders，臀部和脚踝都在正确的路线和作为一个线索，以保持运动腿部挺身而出。 </li><li>对于较弱的人，指示参与者弯曲上面的腿在膝盖以上，以减少努力;保持脚跟接触，仅通过滚动向上和向外移动的膝盖;或仰卧执行。 </li></ol></li><li>髋关节伸展<ol><li>指导参与者撒谎脸躺在一条腿伸直一条腿弯曲。指导参与者，以提高大腿弯曲离开支撑面，保持膝盖弯曲。 </li><li>对于最佳比对:指导参与者收紧腹肌如果有必要保持骨盆稳定。 </li><li>对于较弱的人，指导参与者侧卧与支持低板凳放在参与者背后的顶边执行。对于强大的个人（修改），指示参与者从一双手和膝盖位置开始在地上进行练习。确保回骨盆保持稳定在整个运动。 </li></ol></li><li>膝关节屈曲<ol><li>指导参与者撒谎脸，躺在双腿伸直。指示参与者弯曲膝盖尽可能，保持骨盆和大腿静止和保持臀部上的支撑表面</li><li>为了获得最佳的定位，指导参与者收紧腹部及/或臀部肌肉，保持骨盆不动。 </li><li>对于较弱的人，指导参与者侧卧腿部支撑长椅上或坐执行。 </li></ol></li><li>髋关节外旋<ol><li>指导参与者开始坐姿。指导参与者向外转动膝盖/大腿。 </li><li>为了获得最佳的定位，避免移动到臀部外展，内收或屈曲。鞋跟可滑动后面或相反的临门一脚取决于参与者的舒适度。 </li><li>对于较弱的人，指示参与者执行练习的研究E在仰卧的腿伸直。 </li><li>对于强大的个人，指导参与者在保持在伸展椅子和臀部站在膝盖休息进行锻炼。 </li></ol></li><li>膝关节伸直<ol><li>指导参与者仰卧与锻炼腿部伸直搁腿弯曲。指导参与者从臀部抬高腿部，膝盖保持伸直并停止在休息腿膝盖的高度。 </li><li>为了获得最佳的比对，如果骨盆岩石，收紧腹肌和/或不抬腿高。 </li><li>对于较弱的人，指导参与者侧卧腿部支撑长椅上或坐执行。 </li></ol></li><li>功能锻炼<ol><li>选择最适当的功能锻炼组在每届会议。选择的基础上结合病人的安全，认知和信心水平参与者的能力的功能锻炼。 注:选择examp功能锻炼LES包括:木板面躺着和侧卧;手和膝盖的腿和/或臂升降机（可支持干线健身球，以降低难度）;步骤触摸到替补席（较低的高度，以降低难度）;步骤起坐的长椅（较低的高度，以减少困难）;在行军的地方（仅脚跟提出降低难度）;单腿站立（一只脚在低板凳一脚踩在泡沫块，以利用光用手指触摸在墙上，以单腿站立到移动空间中的自由腿）的变化;坐站（较低的高椅子上，以增加难度;把对方的一只脚着增加难度）;站在向/从蹲（小范围或墙壁滑动，以减少困难）;走宽，阻力带环在脚踝一级踏步。 </li></ol></li><li>家庭运动<ol><li>提供每个参与者一个个性化的家庭计划每个周末。 </li><li>指示参与者的结构如下:执行两组ö˚F髋关节屈曲十重复仰卧使用提供阻力带;执行坐静置3分钟的持续时间;执行所选功能锻炼3分钟时间;在上周末进行一次，每次锻炼。 </li></ol></li><li>练习日志<ol><li>指导学员填写运动日志（ <a href="https://jove.unicartagenaproxy.elogim.com/files/ftp_upload/53449/AppendixstrengthtraininginMS_121415.pdf" target="_blank">见附录</a> ），如本节所述。指导参与者立即这样做每项运动的各个页面下。 </li><li>指导参与者进入今天的日期和记录表进行重复。指导参与者如使用主观体力（RPE）规模0-10的评分（定义为输入工作<a href="https://jove.unicartagenaproxy.elogim.com/files/ftp_upload/53449/AppendixstrengthtraininginMS_121415.pdf" target="_blank">见附录</a> ）。 </li><li>指导参与者进入阻力带和颜色长使用。 注:长度等于电阻频带的循环数目。例如:如果使用最接近保护对象的循环，写"1环"。 </li><li>有教官填写波段目标为明天和参与者知道使用这种颜色和长度的下一届会议。打印一个新的记录表每周每个参与者，并输入按照时间安排如下的重复次数:1-3周做每套重复10次; 4-6周做每组12次重复; 7-9周做每组15次重复; 10-12周做每组重复18次。 </li></ol></li><li>运动强度<ol><li>通过每个参与者的进展分别通过每个练习根据以下原则，并按照培训的教师的临床判断适当的形式和参与者的安全性能评价。 </li><li>根据"主观体力等级"范围推进阻力位如果定位是正确的:等级零通过三个 - 提前在下届会议;点评四至第七 - 提前在下周;评级八个通过十-保持在同一水平，如果形式是正确的，参加者有没有投诉（ 即痛，太多的精力， 等）。 </li><li>继续提示参与者以适当的形式，如果调整​​不正确。 注:疼痛或非常，非常艰苦的努力的投诉（ 即 10个评级）应优先确定阻力位，以及是否维持或减少阻力。 </li><li>每周通过任一的颜色或长度推进阻力波段如下: <ol><li>带的颜色，使用下强度水平带，并保持相同的长度，或在当前波段的相同或更长的长度增加另一个频带。 </li><li>带长度:1循环缩短的乐队。 注:限制是基于拉伸量通过M给定范围内波段otion。典型谱带拉伸限值是两三次静息长度。 </li></ol></li></ol></li><li>培训监控<ol><li>每四个星期，保证测试髋关节屈曲强度用测力计，以确定该进程正在进行中。 注:预见维持目前的实力水平四周，同比增长从前期测试，在八个星期。 </li><li>如果在强度下降时观察到的，重新评估所使用的阻力水平。考虑评估由医生，如果症状进展。 </li></ol></li></ol> 9.测试后评估<ol><li>在完成所需的类剂量一周内安排一个测试会议，每个参与者。 </li><li>重复强度的措施，如在测试前所述。获得屈髋，髋关节伸肌，并用手持测力计臀外展肌的力量。 </li></ol> 10.统计分析<ol><li>计算描述性统计对B比例基线变量 （例如，肌力为髋部屈肌，髋部伸肌和髋关节外展肌）。 </li><li>以确定是否有一组变化的强度在预至后阻力训练使用t检验，或在非正常人群的情况下的Mann-Whitney检验。评估双方的概括力群力（左，右）为每个肌肉群。 </li><li>以确定是否有在强度为单个肌肉的变化确定从基线的百分比变化。使用此为整个集团的个别反馈。使用标准统计软件包，如塔塔。 </li></ol>

<ol>
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M., Chow, J. W., Tillman, M. D., McCoy, S. C., Castellano, V., White, L. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resistance+training+improves+gait+kinematics+in+persons+with+multiple+sclerosis.">Resistance training improves gait kinematics in persons with multiple sclerosis.</a> Arch Phys Med Rehabil. 86 (9), 1824-1829 (2005).</li><li>Kj&#248;lhede, T., Vissing, K., de Place, L., Pedersen, B. G., Ringgaard, S., Stenager, E., Petersen, T., Dalgas, U. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neuromuscular+adaptations+to+long-term+progressive+resistance+training+translates+to+improved+functional+capacity+for+people+with+multiple+sclerosis+and+is+maintained+at+follow-up.">Neuromuscular adaptations to long-term progressive resistance training translates to improved functional capacity for people with multiple sclerosis and is maintained at follow-up.</a> Mult Scler. 21 (5), 599-611 (2015).</li><li>Kj&#248;lhede, T., Vissing, K., Dalgas, U. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Multiple+sclerosis+and+progressive+resistance+training:+a+systematic+review.">Multiple sclerosis and progressive resistance training: a systematic review.</a> Mult Scler. 18 (9), 1215-1228 (2012).</li><li>Dalgas, U., Stenager, E., Lund, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neural+drive+increases+following+resistance+training+in+patients+with+multiple+sclerosis.">Neural drive increases following resistance training in patients with multiple sclerosis.</a> J Neurol. 260 (7), 1822-1832 (2013).</li><li>Dalgas, U., Stenager, E., Jakobsen, J., Petersen, T., Hansen, H. J., Knudsen, C., Overgaard, K., Ingemann-Hansen, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resistance+training+improves+muscle+strength+and+functional+capacity+in+multiple+sclerosis.">Resistance training improves muscle strength and functional capacity in multiple sclerosis.</a> Neurology. 73 (18), 1478-1484 (2009).</li><li>Kurtzke, J. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+new+scale+for+evaluating+disability+in+multiple+sclerosis.">A new scale for evaluating disability in multiple sclerosis.</a> Neurology. 5 (8), 580-583 (1955).</li><li>Kurtzke, J. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rating+neurologic+impairments+in+multiple+sclerosis:+an+expanded+disability+status+scale+(EDSS).">Rating neurologic impairments in multiple sclerosis: an expanded disability status scale (EDSS).</a> Neurology. 33 (11), 1444-1452 (1983).</li><li>Sahrmann, S. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Diagnosis and Treatment of Movement Impairment Syndromes. , (2002).</li><li>Bohannon, R. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reference+values+for+extremity+muscle+strength+obtained+by+hand-held+dynamometry+from+adults+aged+20+to+79+years.">Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years.</a> Arch Phys Med Rehabil. 78 (1), 26-32 (1997).</li><li>Newsome, S. D., Wang, J. Y., Kang, J. Y., Calabresi, P. A., Zackowski, K. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+measures+detect+sensory+and+motor+impairments+in+multiple+sclerosis.">Quantitative measures detect sensory and motor impairments in multiple sclerosis.</a> J Neuro Sci. 305 (1-2), 103-111 (2011).</li><li>Hackney, M., McKee, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Community-based+adapted+tango+dancing+for+individuals+with+Parkinson's+Disease+and+older+adults.">Community-based adapted tango dancing for individuals with Parkinson's Disease and older adults.</a> JoVE. (94), e1-e12 (2014).</li></ol>

财务披露/利益冲突 :有没有利益冲突的报告。 资金来源 :美国国家多发性硬化症协会的研究资助。

该协议描述了使用隔离的肌肉加强与阻力带的人与MS渐进性训练计划。该协议具有与退化性疾病，其强度的限制可损害其走动并维持他们的生活质量能力的个人独特的功能。焦点是关于改善在下肢即用于行走速度，在MS 21重要近端肌肉强度; 4。此协议的一个优点是，它强调孤立的肌肉中适当对准（例如，髋部外展与臀部延伸）。该协议可以个性化，以适应不对称的弱点，深?...

在MS，受损的神经功能通常会导致运动功能障碍，导致无力。已知的是，肌肉无力有助于在MS患者和非活动进一步妥协功能能力1降低每日活性 ; 2。我们的实验室已经表明，弱髋屈肌个体与MS影响行走速度 3，特别是在最薄弱的个体4。弱近端臀部肌肉的走路的意义已显示，在MS以及在其它神经变性条件4; 5。这种恶性循环有助于提高残疾和生活6质量下降; 7。经常锻炼可以提高日常活动8，心肺功能8，9，肌肉力量10，和疲劳8; 11人与MS 12。力量训练是已知的，以促进神经适应性，可导致有利的功能结果，在MS参与者13-16。＆＃160;由于身体康复往往是提供给个人与MS的功能恢复的唯一的治疗方法，它确定什么是最有效的方式来提高强度是至关重要的。 抵抗力量训练进行了评估与上看到肌肉力量或优化增强的最好方法显著变化所需的时间最小量没有明确的共识。的电流审查报告说，阻力训练的研究已经从3〜26周变化的长度，主要针对下肢与来自低MS患中度损伤（具有0-6.5的扩展残疾状态量表）14人; 17; 18 。这些研究主要使用的等速设备进行直接监督健身房训练场所。利用等速设备是分离，强化单一肌肉的一种方式，但它限制一个人的能力来完成练习，而不使用昂贵的设备是不总是访问。阻力带提供控制阻力的方向，以及放置在肢体上的阻力，从而避免应力远侧关节的优点。阻力带还提供了机会，等级在更小增量的电阻，然后与其他设备如与袖口的权重。 对准和运动模式认真解决在运动员的训练，但很少注意了这些因素在慢性变性条件的个体，部分是因为它们的局限性是如此复杂（例如，感觉，运动控制，认知）。需要解决对准演习，以及在日常活动是至关重要的19。很简单，但精心挑选那些在肌肉骨骼综合征与完整的神经系统19个人的分辨率精确地进行救援演习。虽然许多通用锻炼项目阿瓦伊吊牌，它们没有解决在MS中的特定损伤，影响移动性和必要的修改，考虑到疾病的进步性。对于这个计划，我们强调姿势的调整，以及该在的位置上最理想如何肌肉的功能用于完成具体的练习。 在这项研究的目标是创造一个方便，价格低廉，阻力训练的臀部肌肉是推广到有不同程度残疾的个人计划。简单而准确地描述髋加强锻炼在这里适应强调孤立的肌肉加强，并提供了个人进一步适应取决于他们目前的肌肉力量练习的指导方针。建议是由这样的个体可以行使与阻力带中，很容易适应于家庭和复制指定的程序所需的信息的系统方法。

<table><tbody><tr><td>microFET2</td><td>Hoggan Scientific, LLC</td><td></td><td>Digital hand held muscle tester</td></tr><tr><td>REP Bands (all colors)</td><td>Power Systems</td><td>5600-011</td><td>Resistance bands for the exercise program</td></tr><tr><td>TheraBand Latex-Free Exercise Bands (all colors)</td><td>TheraBand</td><td>11726-11730</td><td>Resistance bands for the exercise program</td></tr><tr><td>8&#039;&#039; Cable Ties</td><td>Lowes Home Improvement</td><td>76329</td><td>Tied into the resistance bands to provide places for the carabiner to clip onto</td></tr><tr><td>Door Anchor</td><td>GoFit</td><td></td><td>Anchors the REP bands to doors</td></tr><tr><td>Hollow-Braid Poly Rope</td><td>Home Depot</td><td>140538</td><td>Anchors REP bands to table legs/other fixtures</td></tr><tr><td>Zinc-Plated Steel Hang All</td><td>Home Depot</td><td>550768</td><td>Thigh straps for the hip exercises</td></tr><tr><td>Neoprene Ankle Strap</td><td>TKO</td><td>106 BK</td><td>Ankle strap for leg exercises</td></tr><tr><td>Positron Carabiner</td><td>Black Diamond</td><td>BD2102610000ALL1</td><td>Carabiners to link ankle/thigh strap to REP bands</td></tr><tr><td>Fitness Gear 3mm Mat</td><td>Dick&#039;s Sporting Goods</td><td>41857546</td><td>Yoga mat for exercises on the ground</td></tr><tr><td>1/2 inch, 2 by 2 Exercise Tiles</td><td>FoamTiles</td><td></td><td>Gym matting for exercies on the ground</td></tr><tr><td>Spirit LT Portable Massage Table</td><td>EarthLite</td><td></td><td>Table for hip extension and other exercises that required a raised platform</td></tr><tr><td>Performa Treatment Table</td><td>Sammons Preston</td><td>553736</td><td>Heavy treatment table for testing/anchoring REP bands</td></tr><tr><td>STATA SE 11</td><td>STATA</td><td></td><td>Software for statistical analysis</td></tr><tr><td>STATISTICA</td><td>Dell Software</td><td></td><td>Software for statistical analysis</td></tr></tbody></table>

adapted resistance training improves strength in eight weeks in individuals with multiple sclerosis

髋关节弱点是一种常见的症状影响人与多发性硬化症（MS）的行走能力。据了解，抵抗力量训练（RST）可提高强度与然而MS，个人;目前还不清楚RST的是需要进行强度收益和如何适应髋加强锻炼仅使用阻力带的不同强度的个人时间。本文介绍的方法来建立和实施适应性力量训练计划，用阻力带，为了与MS的个体。方向前后的强度测试，以评估所述力量训练方案的功效也包括在内。安全功能和详细说明，勾勒出每周的节目内容和进展。目前的证据提出表明显著强度增益可以8周开始RST计划内提出。证据也提出表明抵抗力量训练可以成功adapted代表了不同强度的小设备MS个人。

我们发现，从与MS 26个人谁参加了为期12周的下肢向上，阻力训练（PRT）在我们的设备的结果。我们的学员有不同残疾程度与4.0的中位数EDSS（范围:1-6.5），都在平均50.0（11.3）岁（年龄最小的为23年，最老的为64岁），17个是女性，并有12.5（8.7）年平均症状持续时间。 图1显示了髋关节力量提高以下12周的训练（P &lt;0.005所有的臀部肌肉）。用于髋关节屈曲，统计学?...

Watch this Scientific Journal Video about Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis at JoVE.com

Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis

髋关节弱点是一种常见的症状影响多发性硬化患者行走能力。隔离肌肉强化是针对特定弱点的有效方法。本协议描述用健身带，以增加臀部肌肉力量的渐进性训练计划。

改编阻力训练提高力量在八周内的个人与多发性硬化症

Hip weakness is a common symptom affecting walking ability in people with multiple sclerosis (MS). It is known that resistance strength training (RST) can ...

adapted-resistance-training-improves-strength-eight-weeks-individuals

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

16.7K 次观看.  Kennedy Krieger Institute. 髋关节弱点是一种常见的症状影响多发性硬化患者行走能力。隔离肌肉强化是针对特定弱点的有效方法。本协议描述用健身带，以增加臀部肌肉力量的渐进性训练计划。 

视频: Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis

Vascular Occlusion Training for Inclusion Body Myositis: A Novel Therapeutic Approach

Inclusion body myositis (IBM) is a rare idiopathic inflammatory myopathy. It is known to produces remarkable muscle weakness and to greatly compromise function and quality of life. Moreover, clinical practice suggests that, unlike other inflammatory myopathies, the majority of IBM patients are not responsive to treatment with immunosuppressive or immunomodulatory drugs to counteract disease progression1. Additionally, conventional resistance training programs have been proven ineffective in restoring muscle function and muscle mass in these patients2,3. Nevertheless, we have recently observed that restricting muscle blood flow using tourniquet cuffs in association with moderate intensity resistance training in an IBM patient produced a significant gain in muscle mass and function, along with substantial benefits in quality of life4. Thus, a new non-pharmacological approach for IBM patients has been proposed. Herein, we describe the details of a proposed protocol for vascular occlusion associated with a resistance training program for this population.

The present article presents the details pertaining to the application of resistance training associated to vascular occlusion in IBM patients.

血管闭塞包涵体肌炎培训：一种新的治疗方法

Inclusion body myositis (IBM) is a rare idiopathic inflammatory myopathy. It is known to produces remarkable muscle weakness and to greatly compromise ...

科研

医学

A Murine Model of Muscle Training by Neuromuscular Electrical Stimulation

Neuromuscular electrical stimulation (NMES) is a common clinical modality that is widely used to restore1, maintain2 or enhance3-5 muscle functional capacity. Transcutaneous surface stimulation of skeletal muscle involves a current flow between a cathode and an anode, thereby inducing excitement of the motor unit and the surrounding muscle fibers. 
NMES is an attractive modality to evaluate skeletal muscle adaptive responses for several reasons. First, it provides a reproducible experimental model in which physiological adaptations, such as myofiber hypertophy and muscle strengthening6, angiogenesis7-9, growth factor secretion9-11, and muscle precursor cell activation12 are well documented. Such physiological responses may be carefully titrated using different parameters of stimulation (for Cochrane review, see 13). In addition, NMES recruits motor units non-selectively, and in a spatially fixed and temporally synchronous manner14, offering the advantage of exerting a treatment effect on all fibers, regardless of fiber type. Although there are specified contraindications to NMES in clinical populations, including peripheral venous disorders or malignancy, for example, NMES is safe and feasible, even for those who are ill and/or bedridden and for populations in which rigorous exercise may be challenging. 
Here, we demonstrate the protocol for adapting commercially available electrodes and performing a NMES protocol using a murine model. This animal model has the advantage of utilizing a clinically available device and providing instant feedback regarding positioning of the electrode to elicit the desired muscle contractile effect. For the purpose of this manuscript, we will describe the protocol for muscle stimulation of the anterior compartment muscles of a mouse hindlimb.

A murine model of neuromuscular electrical stimulation (NMES), a safe and inexpensive clinical modality, to the anterior compartment muscles is described. This model has the advantage of modifying a readily available clinical device for the purpose of eliciting targeted and specific muscle contractions in mice.

一个小鼠模型，通过神经肌肉电刺激肌肉训练

Neuromuscular electrical stimulation (NMES) is a common clinical modality that is widely used to restore1, maintain2 or enhance3-5 muscle functional ...

Paradigms of Lower Extremity Electrical Stimulation Training After Spinal Cord Injury

Skeletal muscle atrophy, increased adiposity and reduced physical activity are key changes observed after spinal cord injury (SCI) and are associated with numerous cardiometabolic health consequences. These changes are likely to increase the risk of developing chronic secondary conditions and impact the quality of life in persons with SCI. Surface neuromuscular electrical stimulation evoked resistance training (NMES-RT) was developed as a strategy to attenuate the process of skeletal muscle atrophy, decrease ectopic adiposity, improve insulin sensitivity and enhance mitochondrial capacity. However, NMES-RT is limited to only a single muscle group. Involving multiple muscle groups of the lower extremities may maximize the health benefits of training. Functional electrical stimulation-lower extremity cycling (FES-LEC) allows for the activation of 6 muscle groups, which is likely to evoke greater metabolic and cardiovascular adaptation. Appropriate knowledge of the stimulation parameters is key to maximizing the outcomes of electrical stimulation training in persons with SCI. Adopting strategies for long-term use of NMES-RT and FES-LEC during rehabilitation may maintain the integrity of the musculoskeletal system, a pre-requisite for clinical trials aiming to restore walking after injury. The current manuscript presents a combined protocol using NMES-RT prior to FES-LEC. We hypothesize that muscles conditioned for 12 weeks prior to cycling will be capable of generating greater power, cycle against higher resistance and result in greater adaptation in persons with SCI.

Spinal cord injury is a traumatic medical condition that may result in elevated risks of chronic secondary metabolic disorders. Here, we presented a protocol using surface neuromuscular electrical stimulation-resistance training in conjunction with functional electrical stimulation-lower extremities cycling as a strategy to ameliorate several of these medical problems.

脊髓损伤后下肢电刺激训练的模式

Skeletal muscle atrophy, increased adiposity and reduced physical activity are key changes observed after spinal cord injury (SCI) and are associated with ...

行为学

The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the Multiple Sclerosis Performance Test (MSPT), which represents a new approach to quantifying MS related disability. The MSPT takes advantage of advances in computer technology, information technology, biomechanics, and clinical measurement science. The resulting MSPT represents a computer-based platform for precise, valid measurement of MS severity. Based on, but extending the Multiple Sclerosis Functional Composite (MSFC), the MSPT provides precise, quantitative data on walking speed, balance, manual dexterity, visual function, and cognitive processing speed. The MSPT was tested by 51 MS patients and 49 healthy controls (HC). MSPT scores were highly reproducible, correlated strongly with technician-administered test scores, discriminated MS from HC and severe from mild MS, and correlated with patient reported outcomes. Measures of reliability, sensitivity, and clinical meaning for MSPT scores were favorable compared with technician-based testing. The MSPT is a potentially transformative approach for collecting MS disability outcome data for patient care and research. Because the testing is computer-based, test performance can be analyzed in traditional or novel ways and data can be directly entered into research or clinical databases. The MSPT could be widely disseminated to clinicians in practice settings who are not connected to clinical trial performance sites or who are practicing in rural settings, drastically improving access to clinical trials for clinicians and patients. The MSPT could be adapted to out of clinic settings, like the patient&#8217;s home, thereby providing more meaningful real world data. The MSPT represents a new paradigm for neuroperformance testing. This method could have the same transformative effect on clinical care and research in MS as standardized computer-adapted testing has had in the education field, with clear potential to accelerate progress in clinical care and research.

The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report methodologic details on a new test, the Multiple Sclerosis Performance Test (MSPT). This new approach to the objective of quantification of MS related disability provides a computer-based platform for precise, valid measurement of MS severity.

多发性硬化症性能测试（MSPT）:一个iPad为基础的残疾评估工具

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the ...

Improving Strength, Power, Muscle Aerobic Capacity, and Glucose Tolerance through Short-term Progressive Strength Training Among Elderly People

This protocol describes the simultaneous use of a broad span of methods to examine muscle aerobic capacity, glucose tolerance, strength, and power in elderly people performing short-term resistance training (RET). Supervised progressive resistance training for 1 h three times a week over 8 weeks was performed by RET participants (71&#177;1 years, range 65-80). Compared to a control group without training, the RET showed improvements on the measures used to indicate strength, power, glucose tolerance, and several parameters of muscle aerobic capacity. Strength training was performed in a gym with only robust fitness equipment. An isokinetic dynamometer for knee extensor strength permitted the measurement of concentric, eccentric, and static strength, which increased for the RET group (8-12% post- versus pre-test). The power (rate of force development, RFD) at the initial 0-30 ms also showed an increase for the RET group (52%). A glucose tolerance test with frequent blood glucose measurements showed improvements only for the RET group in terms of blood glucose values after 2 h (14%) and the area under the curve (21%). The blood lipid profile also improved (8%). From muscle biopsy samples prepared using histochemistry, the amount of fiber type IIa increased, and a trend towards a decrease in IIx in the RET group reflected a change to a more oxidative profile in terms of fiber composition. Western blot (to determine the protein content related to the signaling for muscle protein synthesis) showed a rise of 69% in both Akt and mTOR in the RET group; this also showed an increase in mitochondrial proteins for OXPHOS complex II and citrate synthase (both ~30%) and for complex IV (90%), in only the RET group. We demonstrate that this type of progressive resistance training offers various improvements (e.g., strength, power, aerobic capacity, glucose tolerance, and plasma lipid profile).

The effect of short-term resistance training on elderly people was investigated through the simultaneous use of several methods. Compared to a control group, many improvements were seen, including on muscle aerobic capacity, glucose tolerance, strength, power, and muscle quality (i.e., protein involved in cell signaling and muscle fiber type composition).

通过长期进步力量训练提高力量，力量，肌肉有氧能力和葡萄糖耐量

This protocol describes the simultaneous use of a broad span of methods to examine muscle aerobic capacity, glucose tolerance, strength, and power in ...

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. The purpose of this study is to report the physical fitness benefits of a training program for independent community-dwelling older adults using an agility ladder. Each training session lasted approximately 30 minutes, and the benefits were achieved with two sessions per week for 14 weeks. Training was timed and involved four different drills and varying levels of difficulty through time. The exercises were performed at the School of Physical Education of the University of Campinas, S&#227;o Paulo state, Brazil. The study participants (n = 16; mean age of 66.9 &#177; 5.0 years) were instructed to perform the exercises as quickly as possible without making mistakes and were assisted by a physical trainer when they made mistakes. Assessments were performed both before and after training using five functional tests (i.e., Illinois agility, five times sit-to-stand, timed up-and-go, walking usual speed, and one-leg stand). Although the study sample was not compared with a control group, the results indicate that training protocols using an agility ladder are easy and practical and improve physical function performance in older adults.

The aim of this study is to present an agility training program for older people. The feasibility of this program is described, and the training protocol demonstrated by video imaging.

一个用于社区居住老年人敏捷阶梯的培训计划

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. ...

Dosage-Adjusted Resistance Training in Mice with a Reduced Risk of Muscle Damage

Progressive resistance training (PRT), which involves performing muscle contractions against progressively greater external loads, can increase muscle mass and strength in healthy individuals and in patient populations. There is a need for precision rehabilitation tools to test the safety and effectiveness of PRT to maintain and/or restore muscle mass and strength in preclinical studies on small and large animal models. The PRT methodology and device described in this article can be used to perform dosage-adjusted resistance training (DART). The DART device can be used as a standalone dynamometer to objectively assess the concentric contractile torque generated by the ankle dorsiflexors in mice or can be added to a pre-existing isokinetic dynamometry system. The DART device can be fabricated with a standard 3D printer based on the instructions and open-source 3D print files provided in this work. The article also describes the workflow for a study to compare contraction-induced muscle damage caused by a single bout of DART to muscle damage caused by a comparable bout of isometric contractions (ISOM) in a mouse model of limb-girdle muscular dystrophy type 2B/R2 (BLAJ mice). The data from eight BLAJ mice (four animals for each condition) suggest that less than 10% of the tibialis anterior (TA) muscle was damaged from a single bout of DART or ISOM, with DART being less damaging than ISOM.

The present protocol describes a unique technique called dosage-adjusted resistance training (DART), which can be incorporated into precision rehabilitation studies performed in small animals, such as mice.

降低肌肉损伤风险的小鼠剂量调整阻力训练

Progressive resistance training (PRT), which involves performing muscle contractions against progressively greater external loads, can increase muscle ...

神经科学

评估力量运动量及其对肥胖患者胰岛素敏感性的影响

Randomized Controlled Trial to Study the Acute Effects of Strength Exercise on Insulin Sensitivity in Obese Adults

An acute session of strength exercise (SE) ameliorates insulin sensitivity (IS) for several hours; however, the effects of SE volume (i.e., number of sets) have not been studied thoroughly. Although it is intuitive that some SE is better than none, and more is better than some for the improvement of IS, high-volume sessions might be challenging for diseased populations to complete, especially obese adults, for whom even a brisk walk can be challenging. This protocol details a randomized clinical trial to assess the acute effects of SE on IS in obese adults. The inclusion criteria are body mass index &#62;30 kg/m2, central obesity (waist circumference &#62;88 cm and &#62;102 cm for women and men, respectively), and age &#62;40 years. Participants will be familiarized with the SE (7 exercises targeting major muscle groups) and then will perform three sessions in a randomized order: session 1 - high-volume session (3 sets/exercise); session 2 - low-volume session (1 set/exercise); session 3 - control session (no exercise). Diet will be controlled the day before and on the day of the sessions. Sessions will be completed at night, and an oral glucose tolerance test will be performed the next morning, from which several indexes of IS will be derived, such as the area under the curve (AUC) of glucose and insulin, the Matsuda index, the Cederholm index, the muscle IS index, and the Gutt index. Based on pilot studies, we expect ~15% improvement in IS (insulin AUC, and Matsuda and Cederholm indexes) after the high-volume session, and ~8% improvement after the low-volume session compared to the control session. This study will benefit individuals who find high-volume SE sessions challenging but still aim to improve their IS by investing 1/3 of their time and effort.

作者聚焦:探索阻力运动量减少对代谢健康的影响 

This study describes a randomized controlled trial protocol aiming at assessing the acute effects of strength exercise volume on insulin sensitivity in obese individuals.

研究力量运动对肥胖成人胰岛素敏感性的急性影响的随机对照试验

An acute session of strength exercise (SE) ameliorates insulin sensitivity (IS) for several hours; however, the effects of SE volume (i.e., number of ...

改编阻力训练提高力量在八周内的个人与多发性硬化症

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研究力量运动对肥胖成人胰岛素敏感性的急性影响的随机对照试验

研究力量运动对肥胖成人胰岛素敏感性的急性影响的随机对照试验

研究力量运动对肥胖成人胰岛素敏感性的急性影响的随机对照试验