Exercise therapy Friday, October 04, 2013, 15:30 - 17:00
A novel approach to low level resistance training in multiple sclerosis; Kaatsu occlusion trainingY. Learmonth, B. Kistler, I. Ensari, B. Sandroff, P. Fitschen, K. Wilund, R. Motl (Urbana, US)
Introduction and purpose: The level of exercise required to achieve strength gains may be too difficult for many with strength deficits due to multiple sclerosis (MS). Thus effective alternate exercise programmes are required in MS. In healthy individuals, occlusion resistance training called Kaatsu (performed at 20-40% of 1RM), whereby blood flow is partially occluded to the working muscle has resulted in larger adaptations than with low resistance alone. Such adaptations would make Kaatsu an ideal training tool for those with MS. We undertook a randomised, double blinded controlled study to identify the safety, acceptability and efficacy of Kaatsu resistance training in MS.
Method: Eight people mildly affected with MS took part in six weeks of thrice weekly resistance training of four lower limb muscles (i.e., leg press (LP), calf raise (CR), leg extension (LE) & leg curl (LC)) while wearing the Kaatsu occlusion cuff. The cuff was inflated (partially restricting blood flow) for the four intervention participants and not inflated for the four control participants. Attrition rates, complaints and adverse events provided data on safety and acceptability. To determine efficacy outcomes included lean body tissue, fat mass, dynamometry and timed 25-foot walk.
Results: No dropouts, complaints, or adverse events were reported, providing some initial safety and acceptability data. Efficacy results suggested walking speed based on the timed 25-foot walk (T25FW) improved only in the intervention group (10%), with minimal change in the control group (-3%)(p = 0.098). The effect size for the change in T25FW approached 1 standard deviation (d = 0.91). Both groups increased strength in lower limb muscles (Intervention; LP=3%, CR=8%, LE=5%, LC=5% and Control; LP=-3%, CR=8%, LE=5%, LC=14%); lean body tissue (i.e. muscle) increased (6%) in all participants, while fat mass decreased in those receiving the intervention (- 9%) only.
Discussion: Results suggest that low level resistance training has the potential to increase muscle mass and strength in those with MS. Kaatsu resistance training appears a safe, acceptable and effective tool for those with MS. Our pilot data suggests this form of training may result in decreased fat mass and significant improvement in T25FW performance for those with mild MS. This novel exercise training method may be particularly useful for those with significant weakness that precludes advanced progressive resistance training.
This study was funded by a grant awarded from the American College of Sports Medicine.
YCL was recipient of a 2012 Du Pré Award from the Multiple Sclerosis International Federation.