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://www.jove.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://www.jove.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://www.jove.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>
	<li>Sutliff, M. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Contribution+of+impaired+mobility+to+patient+burden+in+multiple+sclerosis.">Contribution of impaired mobility to patient burden in multiple sclerosis.</a> Curr Med Res Opin. 26 (1), 109-119 (2010).</li><li>Zwibel, H. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Contribution+of+impaired+mobility+and+general+symptoms+to+the+burden+of+multiple+sclerosis.">Contribution of impaired mobility and general symptoms to the burden of multiple sclerosis.</a> Adv Ther. 26 (12), 1043-1057 (2009).</li><li>Fritz, N. E., Newsome, S. D., Eloyan, A., Marasigan, R. E. R., 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=Longitudinal+relationships+among+posturography+and+gait+measures+in+multiple+sclerosis.">Longitudinal relationships among posturography and gait measures in multiple sclerosis.</a> Neurology. 84 (20), 2048-2056 (2015).</li><li>Zackowski, K. M., Wang, J. L., McGready, J., Calabresi, P. A., Newsome, S. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+sensory+and+motor+measures+detect+change+over+time+and+correlate+with+walking+speed+in+individuals+with+multiple+sclerosis.">Quantitative sensory and motor measures detect change over time and correlate with walking speed in individuals with multiple sclerosis.</a> Mult Scler Relat Disor.4(1):67-71. 4 (1), 67-71 (2015).</li><li>Keller, J. L., Wang, J. I., Kang, J. Y., Hanson, J. A., Kamath, P., Swain, J. O., Raymond, G. V., 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=Strength:+A+relevant+link+to+functional+performance+in+the+neurodegenerative+disease+of+adrenomyeloneuropathy.">Strength: A relevant link to functional performance in the neurodegenerative disease of adrenomyeloneuropathy.</a> Neurorehabil Neural Repair. 26 (9), 1080-1088 (2012).</li><li>Shahrbanian, S., Dugette, P., Kuspinar, A., Mayo, N. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Contribution+of+symptom+clusters+to+multiple+sclerosis+consequences.">Contribution of symptom clusters to multiple sclerosis consequences.</a> Qual Life Res. 24 (3), 617-629 (2015).</li><li>Motl, 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=Physical+activity+and+irreversible+disability+in+multiple+sclerosis.">Physical activity and irreversible disability in multiple sclerosis.</a> Exerc Sport Sci Rev. 38 (4), 186-191 (2010).</li><li>Mostert, S., Kesselring, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+a+short-term+exercise+training+program+on+aerobic+fitness,+fatigue,+health+perception+and+activity+level+of+subjects+with+multiple+sclerosis.">Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis.</a> Mult Scler. 8 (2), 161-168 (2002).</li><li>Newman, M. A., 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=Can+aerobic+treadmill+training+reduce+the+effort+of+walking+and+fatigue+in+people+with+multiple+sclerosis:+a+pilot+study).">Can aerobic treadmill training reduce the effort of walking and fatigue in people with multiple sclerosis: a pilot study).</a> Mult Scler. 13 (1), 113-119 (2007).</li><li>Dalgas, U., 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=Muscle+fiber+size+increases+following+resistance+training+in+multiple+sclerosis).">Muscle fiber size increases following resistance training in multiple sclerosis).</a> Mult Scler. 16 (11), 1367-1376 (2010).</li><li>Dalgas, U., 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=Fatigue,+mood+and+quality+of+life+improve+in+MS+patients+after+progressive+resistance+training.">Fatigue, mood and quality of life improve in MS patients after progressive resistance training.</a> Mult Scler. 16 (4), 480-490 (2010).</li><li>Gutierrez, G. 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，深刻的弱点，或者个人有轻度乏力。相比之下，传统的健身器材通常允许更强的肌肉没有替代优化肌肉对齐功能表现（如髋关节外展与臀部弯曲）。虽然阻力带是inexpens香港专业教育学院相对于健身器材，他们会伸出一段时间，失去了抵抗力。然而，我们发现，一组乐队是有效的为期12周的训练计划，为4人的团体。该协议的其他优点是，它是便宜的，可行的，做一个小团体的设置，只需要很少的设备。最后，我们强调售前和使用定量装置后检查，如手持式测力计，以更好地为个人和团体比较微妙，但显著变化评估。 这些初步结果，从一个更大的研究正在进行拍摄，证明显著强度提高8周的培训内发生。这很重要，因为参与者往往希望知道什么时候会看到改善他们的恢复工作。这些信息可以在激励参与者和获得资金价值。参与者感言都反映这一点，一个例子显示在高点燃文本框。最后，在设计临床试验测试药物或康复干预，看到变化，8周允许有利的结果。 MS的特征是异质的体征和症状，其中弱点发生在与其它症状（ 即认知，感觉，痉挛，共济失调）组合。为了成功地使用此协议，根据个体化的日常表现的程​​序是必不可少的。每个参与者是由它们的组内康复专业的监督，确保:适当调整使用;该演习力度不够;和安全性保持在整个程序。一个修改的协议，以确保有足够的监督是顺序地登记参加者（每周1）。专业的临床判断是谨慎注意皮肤的完整性，安全性，车站，以防跌倒，浑身对齐，以防止第二间行走有价值进制疼痛并发症的运动，并且用于监测充分的环境的温度控制。与其他干预措施的研究，参与者既符合频率和性能质量是一个潜在的问题，所以应该提前解决。在这个协议中使用有效的策略包括提供每月补会话，允许10％的时间-15％，持续时间完成培训课程所需数量。直接监管还有一群充满活力的提供责任和友爱，优化合规的手段。 由于较大的研究的一部分，我们将评估长寿，适用于行走，功能性能，和生活质量的对照研究，这是目前研究的局限性之一。今后，应用该协议到家庭或社区环境将提供更多的机会，让参加者从这项计划中受益。该协议更好地访问可能允许应用程序以罕见的神经退行性疾病也有腿无力的一个关键症状。理想情况下，一个程序，这样可以为社会非临床培训的人员的指导下优化为已经进行了干预帕金森Disease22。需要更多的研究来安全地概括这一信息，同时保持程序的保真度。 参加推荐:一位学员（ 图2A）的报告，"我有一个阶梯凳在我的厨房，我曾经有麻烦攀登上放菜了。现在，这很容易，我只是跳正确那里了！"，"我去了我孙女的生日派对在周末和我的两个女儿评论我如何更好地看起来。他们注意到，我还没有那么累了，并不需要休息，并会走路左右移动更好。这是很好当其他人开始注意到！"

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 border="0" cellpadding="0" cellspacing="0" width="777">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">microFET2</td>
			<td style="width:169px;">Hoggan Scientific, LLC</td>
			<td style="width:147px;"></td>
			<td style="width:248px;">Digital hand held muscle tester</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">REP Bands (all colors)</td>
			<td style="width:169px;">Power Systems</td>
			<td style="width:147px;">5600-011</td>
			<td style="width:248px;">Resistance bands for the exercise program</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">TheraBand Latex-Free Exercise Bands (all colors)</td>
			<td style="width:169px;">TheraBand</td>
			<td style="width:147px;">11726-11730</td>
			<td style="width:248px;">Resistance bands for the exercise program</td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:213px;">8&#39;&#39; Cable Ties</td>
			<td style="width:169px;">Lowes Home Improvement</td>
			<td style="width:147px;">76329</td>
			<td style="width:248px;">Tied into the resistance bands to provide places for the carabiner to clip onto</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">Door Anchor</td>
			<td style="width:169px;">GoFit</td>
			<td style="width:147px;"></td>
			<td style="width:248px;">Anchors the REP bands to doors</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">Hollow-Braid Poly Rope</td>
			<td style="width:169px;">Home Depot</td>
			<td style="width:147px;">140538</td>
			<td style="width:248px;">Anchors REP bands to table legs/other fixtures</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">Zinc-Plated Steel Hang All</td>
			<td style="width:169px;">Home Depot</td>
			<td style="width:147px;">550768</td>
			<td style="width:248px;">Thigh straps for the hip exercises</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">Neoprene Ankle Strap</td>
			<td style="width:169px;">TKO</td>
			<td style="width:147px;">106 BK</td>
			<td style="width:248px;">Ankle strap for leg exercises</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">Positron Carabiner</td>
			<td style="width:169px;">Black Diamond</td>
			<td style="width:147px;">BD2102610000ALL1</td>
			<td style="width:248px;">Carabiners to link ankle/thigh strap to REP bands</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">Fitness Gear 3mm Mat</td>
			<td style="width:169px;">Dick&#39;s Sporting Goods</td>
			<td style="width:147px;">41857546</td>
			<td style="width:248px;">Yoga mat for exercises on the ground</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">1/2 inch, 2 by 2 Exercise Tiles</td>
			<td style="width:169px;">FoamTiles</td>
			<td style="width:147px;"></td>
			<td style="width:248px;">Gym matting for exercies on the ground</td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:213px;">Spirit LT Portable Massage Table</td>
			<td style="width:169px;">EarthLite</td>
			<td style="width:147px;"></td>
			<td style="width:248px;">Table for hip extension and other exercises that required a raised platform</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:213px;">Performa Treatment Table</td>
			<td style="width:169px;">Sammons Preston</td>
			<td style="width:147px;">553736</td>
			<td style="width:248px;">Heavy treatment table for testing/anchoring REP bands</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">STATA SE 11</td>
			<td style="width:169px;">STATA</td>
			<td></td>
			<td style="width:248px;">Software for statistical analysis</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:213px;">STATISTICA</td>
			<td style="width:169px;">Dell Software</td>
			<td></td>
			<td style="width:248px;">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，统计学显著改进是第一下面的8周的训练（p值= 0.013）制成，具有在12周结束时额外改进。使用配对t检验与p值设定为0.017，以控制多重比较，比较各个肌肉群。当我们评估从干预前的每一个人的力量改变干预后，我们看到大部分的sh不同的反应由于良好的改善:超过超过44 N.上半年提高了强度为了证明这一点， 图2显示了与会者谁提高自己的实力，尽管有不同程度的弱点下手臀部肌肉的三个例子图2A显示了单个的例子与不对称髋关节强度（比右左弱）在基线时，此人提出了一个半麻痹的行走模式。随着力量训练，这个人特别获得了髋关节屈曲强度上较弱，左侧。相比之下，髋关节外展和伸肌更对称，双方获得了力量干预后。注意:此人（2A）开始关于髋部弯曲右侧第1级5带在循环3，总计40 N，在100％拉伸和进展到1 5级和1级3带在环路2（1/3较短的总长度），共计67个北，100％的拉伸。 图2B示出了具有非常弱的臀部肌肉℃的个体ompared以控制值（屈髋:195±44 N）5。此人获得了力量在所有三个肌肉和双方的权利，即使有深厚的初始无力左右两侧。注意:这个人（2B）开始在侧卧屈髋锻炼，而不带的权利，发展到做练习仰卧，而不带图2C显示个人谁比较强在他的臀部肌肉在基线，相对的。控制值（屈髋:304±52 N）5。虽然这人只有很轻微的弱点，所有的肌肉显示出以下的力量训练干预22-44 n个数量级的改进。注意这个人（2C）开始关于髋部弯曲的右与第2级5阶和第2级3条带在环路4，总共146北，100％拉伸和进展至第1级5带1平2和所有三个管在环路4的长度增加了一倍，总共469北，100％的拉伸。 图1.屈髋力量。从26个人的折线图与MS显示为屈髋肌牛顿的强度平均值 ±标准差。 （ 一）总结髋关节屈曲强度。 （二）总结髋关节外展肌力。 （ 三）总结髋关节伸展的力量。基地:基线措施;干预前; 4周4周的干预后的意思; 8周:8周干预后的意思; 12周:12周的干预后的平均值。 <img alt="图2" src="/files/ftp_upload/53449/53449fig2.jpg" /> 图强度变化2.三代表性例子，前和耐破强度训练计划后，该条形图显示了平均强度测量值的右和屈髋，伸髋关节和髋外展肌三MS与会者左右两侧。暗柱左髋关节屈曲和更轻的列是正确的髋关节屈曲措施。 （ 一）参加者以著名的屈髋不对称基线（年龄:46岁，女，症状持续时间:4年，EDSS:1）（B）参与者与特别是微弱的臀部肌肉在基线（年龄:58，女，症状持续时间:34年，EDSS:6）。 （ 三）参与者与非常温和疲软臀部肌肉在基线（年龄:37岁，男性，症状持续时间:1年，EDSS:2）。 y轴是强度，以牛顿。 x轴表示参观1左右肌力和第2次访问三个臀部肌肉。前期，是基准或预培训;邮政，是12周或训练后。

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

Nanyang Technological University

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

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 ...

科研

医学

Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets

Pulmonary arterial hypertension (PAH) is a disease affecting distal pulmonary arteries (PA). These arteries are deformed, leading to right ventricular failure. Current treatments are limited. Physiologically, pulsatile blood flow is detrimental to the vasculature. In response to sustained pulsatile stress, vessels release nitric oxide (NO) to induce vasodilation for self-protection. Based on this observation, this study developed a protocol to assess whether an artificial pulmonary pulsatile blood flow could induce an NO-dependent decrease in pulmonary artery pressure. One group of piglets was exposed to chronic hypoxia for 3 weeks and compared to a control group of piglets. Once a week, the piglets underwent echocardiography to assess PAH severity. At the end of hypoxia exposure, the piglets were subjected to a pulsatile protocol using a pulsatile catheter. After being anesthetized and prepared for surgery, the jugular vein of the piglet was isolated and the catheter was introduced through the right atrium, the right ventricle and the pulmonary artery, under radioscopic control. Pulmonary artery pressure (PAP) was measured before (T0), immediately after (T1) and 30 min after (T2) the pulsatile protocol. It was demonstrated that this pulsatile protocol is a safe and efficient method of inducing a significant reduction in mean PAP via an NO-dependent mechanism. These data open up new avenues for the clinical management of PAH.

Pulmonary hypertension is associated with a significant reduction in pulmonary artery pulsatility, contractility and elasticity, contributing to an increase in pulmonary artery pressure and pulmonary resistance. Using a hypoxic piglet model, this study demonstrated that improving pulmonary artery plasticity using a newly developed pulsatile catheter improves hypoxic pulmonary hypertension.

增加肺动脉脉动流改善缺氧性肺动脉高压的仔猪

Pulmonary arterial hypertension (PAH) is a disease affecting distal pulmonary arteries (PA). These arteries are deformed, leading to right ventricular ...

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

This report describes a novel Stata-based application of trigonometric regression modelling to 55 years of multiple sclerosis relapse data from 46 clinical centers across 20 countries located in both hemispheres. Central to the success of this method was the strategic use of plot analysis to guide and corroborate the statistical regression modelling. Initial plot analysis was necessary for establishing realistic hypotheses regarding the presence and structural form of seasonal and latitudinal influences on relapse probability and then testing the performance of the resultant models. Trigonometric regression was then necessary to quantify these relationships, adjust for important confounders and provide a measure of certainty as to how plausible these associations were. Synchronization of graphing techniques with regression modelling permitted a systematic refinement of models until best-fit convergence was achieved, enabling novel inferences to be made regarding the independent influence of both season and latitude in predicting relapse onset timing in MS. These methods have the potential for application across other complex disease and epidemiological phenomena suspected or known to vary systematically with season and/or geographic location.

Combining plot analysis with trigonometric regression is a robust method for exploring complex, cyclical phenomena such as relapse onset timing in multiple sclerosis (MS). This method enabled unbiased characterisation of seasonal trends in relapse onset permitting novel inferences around the influence of seasonal variation, ultraviolet radiation (UVR) and latitude.

季节变化的三角建模的方法证明与多发性硬化症复发数据

This report describes a novel Stata-based application of trigonometric regression modelling to  55 years of multiple sclerosis relapse data from 46 ...

A Protocol for the Use of Remotely-Supervised Transcranial Direct Current Stimulation (tDCS) in Multiple Sclerosis (MS)

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that uses low amplitude direct currents to alter cortical excitability. With well-established safety and tolerability, tDCS has been found to have the potential to ameliorate symptoms such as depression and pain in a range of conditions as well as to enhance outcomes of cognitive and physical training. However, effects are cumulative, requiring treatments that can span weeks or months and frequent, repeated visits to the clinic. The cost in terms of time and travel is often prohibitive for many participants, and ultimately limits real-world access. 
Following guidelines for remote tDCS application, we propose a protocol that would allow remote (in-home) participation that uses specially-designed devices for supervised use with materials modified for patient use, and real-time monitoring through a telemedicine video conferencing platform. We have developed structured training procedures and clear, detailed instructional materials to allow for self- or proxy-administration while supervised remotely in real-time. The protocol is designed to have a series of checkpoints, addressing attendance and tolerability of the session, to be met in order to continue to the next step. The feasibility of this protocol was then piloted for clinical use in an open label study of remotely-supervised tDCS in multiple sclerosis (MS). This protocol can be widely used for clinical study of tDCS.

A Protocol for the Use of Remotely-Supervised Transcranial Direct Current Stimulation tDCS in Multiple Sclerosis MS

The goal of this pilot study is to describe a protocol for the remotely-supervised delivery of transcranial direct current stimulation (tDCS) so that the procedure maintains standards of in-clinic practice, including safety, reproducibility, and tolerability. The feasibility of this protocol was tested in participants with multiple sclerosis (MS).

一个协议，用于远程监督经颅直流电刺激（TDCS）在多发性硬化症的使用（MS）

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that uses low amplitude direct currents to alter cortical ...

Depletion of Mouse Cells from Human Tumor Xenografts Significantly Improves Downstream Analysis of Target Cells

The use of in vitro cell line models for cancer research has been a useful tool. However, it has been shown that these models fail to reliably mimic patient tumors in different assays1. Human tumor xenografts represent the gold standard with respect to tumor biology, drug discovery, and metastasis research 2-4. Tumor xenografts can be derived from different types of material like tumor cell lines, tumor tissue from primary patient tumors4 or serially transplanted tumors. When propagated in vivo, xenografted tissue is infiltrated and vascularized by cells of mouse origin. Multiple factors such as the tumor entity, the origin of xenografted material, growth rate and region of transplantation influence the composition and the amount of mouse cells present in tumor xenografts. However, even when these factors are kept constant, the degree of mouse cell contamination is highly variable.
Contaminating mouse cells significantly impair downstream analyses of human tumor xenografts. As mouse fibroblasts show high plating efficacies and proliferation rates, they tend to overgrow cultures of human tumor cells, especially slowly proliferating subpopulations. Mouse cell derived DNA, mRNA, and protein components can bias downstream gene expression analysis, next-generation sequencing, as well as proteome analysis 5. To overcome these limitations, we have developed a fast and easy method to isolate untouched human tumor cells from xenografted tumor tissue. This procedure is based on the comprehensive depletion of cells of mouse origin by combining automated tissue dissociation with the benchtop tissue dissociator and magnetic cell sorting. Here, we demonstrate that human target cells can be can be obtained with purities higher than 96% within less than 20 min independent of the tumor type.

Human tumor xenografts are vascularized and infiltrated by cells of mouse origin during the growth phase in vivo. To circumvent the bias caused by these contaminating cells during downstream analysis, we developed a method allowing for comprehensive depletion of all mouse cells by magnetic cell sorting.

从人类肿瘤异种移植的小鼠细胞的消耗显着改善靶细胞下游分析

The use of in vitro cell line models for cancer research has been a useful tool. However, it has been shown that these models fail to reliably mimic ...

Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty

Approximately 1.2 million people in the United States live with HIV infection. Medical advancements have increased the life expectancy and this cohort is aging. HIV-positive individuals have a high incidence of frailty (~20%) characterized by depression and sedentary behavior. Exercise would be healthy, but due to the frail status of many HIV-positive individuals, conventional exercise is too taxing. The aim of this study was to evaluate the effectiveness and acceptability of a novel game-based training program (exergame) in ameliorating some aspects of frailty in HIV-infected individuals. Ten older people living with HIV were enrolled in an exergame intervention. Patients performed balance exercises such as weight shifting, ankle reaching, and obstacle crossing. Real-time visual/audio lower-extremity joint motion feedback was provided using wearable sensors to assist feedback and encourage subjects to accurately execute each exercise task. Patients trained twice a week for 45 min for 6 weeks. Changes in balance, gait, psychosocial parameters and quality of life parameters were assessed at the beginning, midterm and at conclusion of the training program. Ten patients completed the study and their results analyzed. The mean age was 57.2 &#177; 9.2 years. The participants showed a significant reduction in center of mass sway (78.2%, p = .045) during the semi-tandem balance stance with eyes closed and showed a significant increase in gait speed during a dual task motor-cognitive assessment (9.3%, p = .048) with an increase in stride velocity of over 0.1 m/sec. A significant reduction in reported pain occurred (43.5%, p = .041). Preliminary results of this exergame intervention show promise in improving balance and mobility while requiring older people living with HIV to be more active. The exergame can be continued at home and may have long term as well as short-term benefits for ameliorating frailty associated with HIV infection.

Persons infected with HIV are often frail, depressed and live a sedentary lifestyle for which conventional exercise is too taxing. Here, we present an exercise protocol that ameliorates aspects of frailty in HIV-infected persons. An exergame integrating cognitive control was developed using biosensors that measured balance, weight-shifting and obstacle crossing.

老年人艾滋病感染者健身游戏平衡改善，流动性和可改善虚弱的几个问题

Approximately 1.2 million people in the United States live with HIV infection. Medical advancements have increased the life expectancy and this cohort is ...

Bioluminescence and Near-infrared Imaging of Optic Neuritis and Brain Inflammation in the EAE Model of Multiple Sclerosis in Mice

Experimental autoimmune encephalomyelitis (EAE) in SJL/J mice is a model for relapsing-remitting multiple sclerosis (RRMS). Clinical EAE scores describing motor function deficits are basic readouts of the immune-mediated inflammation of the spinal cord. However, scores and body weight do not allow for an in vivo assessment of brain inflammation and optic neuritis. The latter is an early and frequent manifestation in about 2/3 of MS patients. Here, we show methods for bioluminescence and near-infrared live imaging to assess EAE evoked optic neuritis, brain inflammation, and blood-brain barrier (BBB) disruption in living mice using an in vivo imaging system. A bioluminescent substrate activated by oxidases primarily showed optic neuritis. The signal was specific and allowed the visualization of medication effects and disease time courses, which paralleled the clinical scores. Pegylated fluorescent nanoparticles that remained within the vasculature for extended periods of time were used to assess the BBB integrity. Near-infrared imaging revealed a BBB leak at the peak of the disease. The signal was the strongest around the eyes. A near-infrared substrate for matrix metalloproteinases was used to assess EAE-evoked inflammation. Auto-fluorescence interfered with the signal, requiring spectral unmixing for quantification. Overall, bioluminescence imaging was a reliable method to assess EAE-associated optic neuritis and medication effects and was superior to the near-infrared techniques in terms of signal specificity, robustness, ease of quantification, and cost.

We show a technique for in vivo live bioluminescence and near-infrared imaging of optic neuritis and encephalitis in the experimental autoimmune encephalomyelitis (EAE) model for multiple sclerosis in SJL/J mice.

多发性硬化症的小鼠模型EAE视神经炎及脑部炎症的生物发光和近红外成像

Experimental autoimmune encephalomyelitis (EAE) in SJL/J mice is a model for relapsing-remitting multiple sclerosis (RRMS). Clinical EAE scores describing ...

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 ...

Muscle Imbalances: Testing and Training Functional Eccentric Hamstring Strength in Athletic Populations

Many hamstring injuries that occur during physical activity occur while the muscles are lengthening, during eccentric hamstring muscle actions. Opposite of these eccentric hamstring actions are concentric quadriceps actions, where the larger and likely stronger quadriceps straighten the knee. Therefore, to stabilize the lower limbs during movement, the hamstrings must eccentrically combat against the strong knee-straightening torque of the quadriceps. As such, eccentric hamstring strength expressed relative to concentric quadricep strength is commonly referred to as the &#34;functional ratio&#34; as most movements in sports require simultaneous concentric knee extension and eccentric knee flexion. To increase the strength, resiliency, and functional performance of the hamstrings, it is necessary to test and train the hamstrings at different eccentric speeds. The main purpose of this work is to provide instructions for measuring and interpreting eccentric hamstring strength. Techniques for measuring the functional ratio using isokinetic dynamometry are provided and sample data will be compared. Additionally, we briefly describe how to address hamstring strength deficiencies or unilateral strength differences using exercises that specifically focus on increasing eccentric hamstring strength.

The hamstrings are a group of muscles that are sometimes problematic for athletes, resulting in soft tissue injury in the lower limbs. To prevent such injuries, functional training of the hamstrings requires intensive eccentric contractions. Additionally, hamstring function should be tested in relation to quadricep function at different contraction speeds.

肌肉失衡: 运动人群功能性偏心肌筋强度的检测与训练

Many hamstring injuries that occur during physical activity occur while the muscles are lengthening, during eccentric hamstring muscle actions. Opposite ...

Involving Individuals with Developmental Language Disorder and Their Parents/Carers in Research Priority Setting

A protocol for involving individuals presenting with developmental language disorder (DLD) (iDLD) and their parents/carers (iDLDPC) in a research priority setting exercise is presented.
iDLD have difficulties with communication skills, such as understanding language, word-finding and discourse. Such difficulties mean existing research priority setting protocols are difficult for iDLD to access, since they require sophisticated communication skills. Thus, a novel protocol for involving iDLD in these exercises is warranted. The same protocol is recommended for use with iDLDPC, to ensure accessibility.
The protocol is presented in 4 steps. Step 1 describes a program of activities delivered by trained, specialist DLD speech and language therapists (SLTs) that prepares iDLD/iDLDPC for involvement. Step 2 outlines an approach to elicit iDLD/iDLDPC&#8217;s opinions on research priorities. Steps 3 and 4 describe methods to analyze and integrate this data at multiple stages of the research priority setting process.
9 trained specialist DLD SLTs delivered steps 1 and 2. 17 iDLDs and 25 iDLDPCs consented to involvement. Opinions from all participants were elicited, and this data was used to influence the process and output of the exercise.
An advantage of this protocol is its accommodation of the heterogeneity in support needs of iDLD/iDLDPC, through a menu of options, whilst also providing a structured framework. Due to the novelty of the protocol, the methods for data integration were developed by the research group. These are potential limitations of the protocol, and may bring the reliability and validity under scrutiny, which are yet to be tested.
This protocol enables meaningful involvement of iDLD/iDLDPC in&#160;research priority setting and could be utilized for people with other kinds of speech, language or communication needs. Further research should evaluate the effectiveness of the protocol and whether it can be adapted for involvement of such populations in other research studies.

A protocol to enable individuals with developmental language disorder (DLD) and their parents/carers to meaningfully participate in a research priority setting exercise is established. The protocol includes a defined program of activities for data collection, and methods to incorporate this data into the broader research priority setting process.

让发育性语言障碍患者及其父母/照顾者参与研究重点设定

A protocol for involving individuals presenting with developmental language disorder (DLD) (iDLD) and their parents/carers (iDLDPC) in a research priority ...