Article Title



Whitley Stone1, Dano Tolusso1, Catie Duchette2, Grant Malone1, Angie Dolan3. 1Western Kentucky University, Bowling Green, KY. 2Alabama College of Osteopathic Medicine, Dothan, AL. 3Hanover College, Hanover, IN.

BACKGROUND: Eccentric resistance training (ERT) is a unique exercise modality in that individuals can complete greater volumes of muscular work without a proportional uptake of oxygen or expenditure of energy. In this way, ERT may be an optimal training tool for individuals with diminished exercise capacity, such as those with neurological deficits (e.g., cerebral palsy, multiple sclerosis, Parkinson’s disease, stroke). Though much is known on ERT, little is available to evaluate the impact of negative work on functional outcomes in a population with neurological conditions. METHODS: This meta-analysis followed PRISMA search guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) and served to evaluate the efficacy of ERT against conventionally applied therapeutic modalities and full range of motion weightlifting. Primary outcomes of interest included walking speed (m/s), dynamic balance (Timed Up and Go), and muscular strength (maximum voluntary isometric contraction). Inclusion criteria were (1) peer-reviewed publications, (2) available in English, (3) case-control (activity-based prescription + matched neurological condition) design, (4) sample size was greater than two, and (5) at least one dependent variable of interest was assessed. ES were nested within studies to account for non-independence due to multiple effects coming from a single investigation. RESULTS: Twelve studies of human subjects (n=297) and 47 standardized mean differences (SMD) were included in a three-level model with restricted maximum-likelihood parameter estimation. The multilevel model revealed a small, albeit non-significant effect on performance when comparing traditional therapy or weightlifting and ERT (SMD: 0.136; 96; 95% CI: -0.0002, 0.050). Furthermore, the SMD were homogenous in nature with the variability being predominantly explained by sampling error, Q(df 46)=19.17, p=0.99, I2=0.01%. CONCLUSIONS: There appears to be no difference between the efficacy of 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. 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.

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