The effects of 10,000 voluntary contractions over 8 weeks on the strength of very weak muscles in people with spinal cord injury: a randomised controlled trial

Spinal Cord, 2020 · DOI: https://doi.org/10.1038/s41393-020-0439-1 · Published: February 21, 2020

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

This study investigated whether doing 10,000 repetitions of muscle contractions over 8 weeks could improve the strength of very weak muscles in people with spinal cord injury (SCI). Participants were divided into two groups: one group did the exercises in addition to usual care, and the other group received usual care alone. The researchers measured muscle strength, participants' perceptions of their strength and function, and therapists' predictions of the participants' final strength to see if the exercise program had any effect. The study found that doing 10,000 muscle contractions had either no effect or a very small effect on improving muscle strength in people with SCI.

Study Duration

8 weeks

Participants

120 people with recent SCI

Evidence Level

Level 1, Randomized Controlled Trial

Key Findings

1
The mean between-group difference of voluntary strength at 8 weeks was 0.4/13 points (95% conﬁdence interval −0.5 to 1.4) in favour of the Treatment Group.
2
There were no notable between-group differences on any secondary outcome.
3
Participants in the Treatment Group perceived that their strength improved more than those in the Control Group.

Research Summary

This multi-center randomized controlled trial aimed to determine the effect of 10,000 voluntary contractions over 8 weeks on the strength of very weak muscles in people with SCI. The study found that 10,000 isolated contractions of very weak muscles in people with SCI over 8 weeks has either no or a very small effect on voluntary strength. Both groups got stronger, highlighting the challenge of determining the effect of treatments over and above natural recovery and usual care.

Practical Implications

Limited Effectiveness

High-repetition isolated muscle contractions may not be an effective strategy for improving strength in very weak muscles following SCI.

Need for Further Research

More research is needed to identify effective ways to increase strength in very weak muscles of people with SCI.

Re-evaluation of Current Practices

Physiotherapy practices involving high-repetition isolated contractions for very weak muscles should be re-evaluated for their effectiveness.

Study Limitations

1
The minimally worthwhile treatment effect is somewhat arbitrary and depends on people’s perspectives.
2
Greater gains in muscle strength can be achieved when training is performed within the context of a functional skill.
3
Ten thousand contractions over 8 weeks may not be sufﬁcient to increase strength in the very weak muscles of people with SCI.

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