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This systematic review with a meta-analysis of studies was carried out to evaluate the potential of overwork weakness on the basis of grip strength of dominant and nondominant hands in individuals with Charcot-Marie-Tooth disease (CMT). Numerous electronic databases were searched from the earliest records to February 2016. Studies of any design including participants older than 18 years of age with a confirmed diagnosis of CMT that measured grip strength of both hands using dynamometric testing were eligible for inclusion. Of 12 593 articles identified following removal of duplicates, five articles fulfilled the criteria. A total of 166 participants, mostly with CMT1 or CMT2, were described from the studies included. Hand and finger pinch grip strength for the dominant compared with the nondominant hand was not statistically different. There is no definitive evidence that preferential use of the dominant hand in CMT impairs function relative to the nondominant hand. Thus, robust exercise trials of progressive resistance training are needed to understand the extent of adaptations possible and provide evidence of the safety of such regimens.

The aim of this study was to investigate the effect of neuromuscular electrical stimulation burst duty cycle (BDC) and current type (sinusoidal alternating current [sAC] vs. rectangular alternating current [rAC]) on the electrically induced isometric torque (EIT) and discomfort. Pulsed current (PC) stimulation, which corresponds to one pulse rAC, was included in testing.A repeated-measures design was used. The left quadriceps of 22 healthy subjects (mean ± SD age, 33 ± 8 yrs) were stimulated alternately with sAC and rAC current bursts (4-kHz carrier frequency; 71 bursts per second burst frequency) to produce isometric contractions. A range of BDCs were tested for sAC (7%-50%) and rAC (2%-18%) stimulation at fixed intensities while EIT and discomfort were recorded. BDC presentation order was randomized.Overall, both current types elicited peak EIT at ∼14% BDC (range, 7%-21%). Significantly more EIT was produced by rAC than by sAC stimulation (P0.005). Discomfort increased with BDC and was similar for both current types.The study confirmed previous findings that conventional sAC stimulation (50% BDC) and pulsed current stimulation (rAC with 2% BDC) used in sports and rehabilitation produce similar EIT levels. However, rAC stimulation at low BDC (7%-18%) was more effective (+35% torque produced with similar discomfort) than pulsed current or conventional sAC.

This study compared acute exercise responses during arm cranking, functional electrical stimulation (FES)-assisted leg cycling, and combined arm and leg ("hybrid") cycling in individuals with spinal cord injury during maximal and submaximal exercise.Nine male subjects with long-standing neurological lesions from C7 to T12 were recruited. All subjects performed arm crank ergometry (ACE), FES leg cycle exercise (FES-LCE), combined ACE + FES-LCE, and cycling on a hybrid FES tricycle (HYBRID). They were assessed for their peak exercise responses in all four modalities. Subsequently, their submaximal heart rates (HR), cardiac outputs (Q), stroke volumes (SV), and arteriovenous oxygen extractions (Ca-Cv)O2 were measured at 40%, 60%, and 80% of mode-specific V˙O2peak.Arm exercise alone and arm + leg exercise resulted in significantly higher V˙O2peak and HRpeak compared with FES-LCE (P0.05). Submaximal V˙O2 during FES-LCE was significantly lower than all other modalities across the range of exercise intensities (P0.05). ACE elicited 70%-94% higher steady-state V˙O2, and HYBRID evoked 99%-148% higher V˙O2 compared with FES-LCE. Steady-state FES-LCE also produced significantly lower Q, HR, and (Ca-Cv)O2. ACE evoked 31%-36% higher Q and 19%-47% greater HR than did FES-LCE. HYBRID elicited 31%-49% greater Q and 23%-56% higher HR than FES-LCE.Combined arm and leg exercise can develop a higher oxygen uptake and greater cardiovascular demand compared with ACE or FES-LCE alone. These findings suggested that combined arm + leg FES training at submaximal exercise intensities may lead to greater gains of aerobic fitness than would arm exercise alone. These data also proffered that FES leg cycling exercise by itself may be insufficient to promote aerobic fitness in the spinal cord injury population.