A randomized clinical trial on the efficacy of strength training in neuromuscular disorders was performed. The study population included 33 patients with myotonic dystrophy and 29 with hereditary motor and sensory neuropathy (HMSN); the trial lasted 24 weeks. Training of leg musculature was performed 3 times a week with weights adapted to the actual strength of each subject. Strength was evaluated by isokinetically measured knee torques and by endurance time. Functional abilities were measured by time-scored activities and questionnaires. No statistically significant training effects were found in myotonic dystrophy patients. A moderate increase in knee torques and a subjective improvement in leg related activities were reported in HMSN patients. Time scores did not change. Other studies report more impressive training effects. This may be due to methodologic errors in these studies. They were based on before-after comparisons and used the same tools for training and evaluation. If such an analysis is performed in our training groups high training effects are also suggested. Therefore, it seems imperative to perform randomized clinical trials in order to properly evaluate training effects. Because training in rehabilitation is, above all, intended to improve functionality, measurement tools have to cover these aspects preferentially.

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