Enhancing neural drive after maximal strength training in multiple sclerosis patients

Multiple sclerosis (MS) affects 2.1 million adults and is a chronic disorder of the central nervous system, being the most frequent neurological disease-causing disability in young and middle-aged people. The exact aetiology of MS remains elusive, but epidemiological studies show that it is a multifactorial disease likely caused by a complex interaction between genetic and environmental factors). The clinical manifestations of MS are reflected in the broad range of symptoms in persons with MS. Moreover, the clinical indices of MS include a reduced capacity to completely activate the muscles of the lower limb and a reduced capacity to drive active motor units at high frequencies. Accordingly, the strength of the lower limb muscles of MS patients is 30-70% lower compared to healthy control subjects, highlighting that muscle weakness is a common symptom of MS. Overall, the reduction in muscle strength reduces quality of life (QOL), increases risk of falls, reduces gait speed, reduces balance and people with reduced muscle strength live less. However, there is growing evidence that regular strength-training increases neuromuscular activation in skeletal muscles which by default increases muscle strength, thus, targeting muscle-strength is a viable option for improving outcomes and QOL for MS patients. Therefore, the proposed PhD will investigate the efficacy of strength training as a new simple and cost-effective treatment for improving muscle strength and activation in MS patients and study the associated neurological mechanisms to further the knowledge about strength training in clinical populations. Strength training could be the key to developing a simple, effective and translatable rehabilitation program for MS patients: In summary, a loss in muscle-strength and reduced neuromuscular activation are key features of MS. Strength training is capable of improving muscle-strength which makes it a promising new treatment that is cost-effective.