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31-07-2011 | Article

Resistance training successful for musculoskeletal rehabilitation

Abstract

Free abstract

MedWire News: Resistance training (RT) is a useful tool in the rehabilitation of a variety of musculoskeletal conditions, according to UK researchers.

The team found that RT can increase muscle strength, reduce pain, and improve functional ability in patients suffering from chronic low back pain (CLBP), knee osteoarthritis, and chronic tendinopathy, as well as those under recovery from hip replacement surgery.

Writing in the British Journal of Sports Medicine, Jakob Kristensen and Andy Franklyn-Miller, from the Centre for Human Performance, Rehabilitation, and Sports Medicine in Epsom, explain that previous studies have shown that musculoskeletal RT can increase muscle size, maximal strength, and muscle power in healthy populations.

However, little is known about the effects of RT in an injured population, and even less is known about what constitutes the optimal guidelines for its use.

To investigate further, the researchers performed a systematic literature review using data from 1545 rehabilitation patients who had participated in structured RT programs. The effects of RT on maximal strength, functional ability, alleviation of pain, and quality of life among these patients was assessed.

In total, 549 patients suffered with CLBP, 299 suffered with tendinopathy, and 433 had knee osteoarthritis. Anterior cruciate ligament (ACL) reconstruction and hip replacement surgery had been performed in 189 and 75 patients, respectively.

Based on the literature, Kristensen and Franklyn-Miller report that RT is a "valid therapeutic tool" in the treatment of the most common musculoskeletal injuries, especially those of a chronic variety, such as recurrent low back pain, knee osteoarthritis, and patellar tendinopathy.

Although the beneficial effects of RT were apparent in these chronic conditions, the authors note that the effectiveness of RT in a postsurgical setting seems to vary. Indeed, high-intensity RT does not appear feasible post-ACL reconstruction surgery, as it can stress the knee joint and, consequently, jeopardizes the integrity of the new graft. However, RT shows clear beneficial effects when commenced shortly after hip replacement surgery.

The researchers explain that previous studies have indicated that RT in a rehabilitation context should be less intense than what is used in healthy individuals, based on concerns that high-intensity RT could potentially be injurious and detrimental in an already injured population.

However, in the present study, it appears that a high-intensity RT approach (≥70% of repetitions maximum) is well tolerated by patients. This approach "does not increase the likelihood of injury, provided that patients are gradually introduced to heavier loads through periodised RT," conclude the researchers.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Nikki Withers