Many of us have tried and given up strength training at some point: An injury, tendonitis or surgery may have resulted in us having a spell of physiotherapy and guided exercise sessions at a gym. After a period of support, we are left to ourselves. After a while, we get bored. We drop out.
Imagine you have been diagnosed with multiple sclerosis (MS) or Parkinson’s disease, conditions that cause the patient’s strength to diminish and their muscles to become weaker. The good news is that strength training slows the development of the disease. But how can you motivate yourself to keep up your exercise routine once your period of rehabilitation is over?
“Not everyone wants to go to the gym,” says SINTEF senior researcher Mariann Sandsund.
Mariann Sandsund is a senior researcher at SINTEF’s Department of Health. Photo: SINTEF
She is leading the project which will give patients, and anyone else interested in doing strength training the right way, the chance to do intensive strength training based on the right technique, using an app on their phone at home. The researchers call it “AI-powered digital medicine,” and the aim is for the software to be classified as a medical device.
Bone strength and cardiac capacity the key factors for health
The Myworkout Go app has already been developed for cardio training, based on the popular 4×4 method of high-intensive interval training. Behind the app is founder Knut Løkke, along with NTNU researchers Jan Hoff and Jan Helgerud. They are also behind the Treningsklinikken fitness clinic in Trondheim, which offers rehabilitation based on the same training principles.
“Leg strength and cardiovascular capacity are the most important factors when it comes to health. That’s what the research shows us and it’s a responsibility we feel we have to take seriously,” said Løkke.
It’s a type of training that results in stronger, higher frequency nerve signals being sent from the brain to the muscles. It is precisely this signal generation and transmission that is poor in patients with MS or Parkinson’s disease.
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New features for intensive strength training are now set to be added to the app. The aim is for the app to be approved as a medical device by the Food and Drug Administration in the United States and the Medical Device Regulation in the European Union.
Knut Løkke is CEO and largest shareholder of Myworkout AS. Photo: Private
The founders have an ambition to ensure that the app can be used anywhere in the world, not just in training clinics.
“We have quite a few examples of training producing good results in patients participating in studies, but they are surrounded by a lot of resources during such studies. We want to create something that enables them to exercise without anyone standing there, helping them,” said Løkke.
Training for the nervous system
“Intensive strength training” is where the exercises are done with a high load and only a small number of repetitions.
“Research shows that this form of training is especially useful for enhancing the ability of the nervous system to send impulses from the brain to the muscles,” said Sandsund.
In the sports world, this form of training is used by athletes who want to develop high muscle strength without building up too much muscle mass.
“Look at high jumpers. There’s no advantage in them having a large, heavy body when they leap over the bar. They need a lot of power, but they also need to be light.
High jumpers therefore do a lot of strength training with heavy weights,” explains the SINTEF researcher.
“It’s a type of training that results in stronger, higher frequency nerve signals being sent from the brain to the muscles. It is precisely this signal generation and transmission that is poor in patients with MS or Parkinson’s disease.
One-legged squats as home training
In Norway, researchers at NTNU have been at the forefront of research into high-intensity strength training for MS and Parkinson’s patients. They have carried out numerous studies which have shown that maximal strength training helps to increase neural signal strength. An important point is that it is more important to increase the load than do many repetitions.
Many patients with these conditions experience weakening of their legs, and leg presses are therefore key.
This is an exercise where you sit on the equipment and push a weight with your feet. The weight should be pushed as fast and as hard as possible until your leg is extended. This leads to full activation of the nervous system. The exercise must be repeated with four repetitions in four series, each two minutes apart, with as heavy as load a possible.
“Research shows that this form of exercise is especially useful for enhancing the ability of the nervous system to send impulses from the brain to the muscles”.
“At the gym, you can do this exercise on the gym equipment. At home, you can do it with one-legged squats. It’s quite hard, but this is how you can achieve full activation of your nervous system if you do it the right way,” said Sandsund.
Artificial intelligence offers high accuracy
An app on your phone must therefore be able to record the movements that you make in order to assess muscle strength and monitor changes and, where necessary, correct them. It should be enough to have your phone in your pocket while you are doing the exercise.
“The aim is for the app to be approved as a medical device that the patient can get on prescription. This means it has to be very, very accurate. Among other things, we will use artificial intelligence to train it to be as precise as possible,” said Sandsund.
It’s really cool to have technology that can calculate the strength of your legs.
Technology will also be developed for motivation and follow-up. This work is being done at Myworkout in collaboration with NTNU. For founder Knut Løkke, the collaboration with SINTEF and NTNU is worth its weight in gold.
“It’s really cool to have technology that can calculate the strength of your legs. Being able to have your phone in your pocket and record your strength exercises and how much you train, how strong you are and how strong you’re going to be in the future. It offers unique opportunities as regards motivation and scalability,” said Løkke.
At the same time, he is concerned that it must be credible, too.
“This is where SINTEF’s role is so important. They possess world-class expertise in a wide range of disciplines, as well as the implementation capacity we need to succeed on the international stage,” he said.
Sources: Helgerud J, Thomsen SN, Hoff J, Strandbråten A, Leivseth G, Unhjem R, Wang E. Maximal strength training in patients with Parkinson’s disease: impact on efferent neural drive, force-generating capacity, and functional performance. J Appl Physiol. 2020.
Fimland MS, Helgerud J, Gruber M, Leivseth G, Hoff J. Enhanced neural drive after maximal strength training in multiple sclerosis patients. Eur J Appl Physiol. 2010.
