Some of the common symptoms associated with Multiple Sclerosis are fatigue, pain and limited mobility. These are all barriers to exercise. So if you have MS, why do we recommend exercise?
Aerobic exercise is any exercise that increases the heart rate and causes the body to use energy. This can include dancing, walking, bike riding, water aerobics or steps. Aerobic exercise has additional effects on muscle strength, balance and sensation.
One study compared 22 people divided into an experimental group and control group (Sutherland, Anderson & Stoove, 2001). The people in group A (Experimental) received 1 hour of aquatic therapy, 3 times a week for 10 weeks. The people in group B (Control) did not receive any extra physical activity coaching. After 10 weeks, results found that the people who did aquatic therapy had better social functioning and reduced pain and fatigue.
A review in the Sports Medicine journal found that exercise for patients with Multiple Sclerosis results in improved oxygen capacity, improved function in daily life, improved muscle endurance, improved lung function and delayed fatigue levels (White & Dressendorfer, 2004).
The NICE Guidelines were developed to guide health professionals to the best practice and recommendations for treating adults with Multiple Sclerosis (NICE.org, 2019). The NICE Guidelines recommend both aerobic exercise and weights training as ways for people with Multiple Sclerosis to reduce fatigue. The guidelines also recommend that adults keep exercising in the long term after exercise program completion, to maintain benefits and continue to improve. If there is more than one activity that is suitable, health professionals are recommended to offer all choices based on whether the patient can continue with the exercise after the therapy period ends.
In short, exercise needs to be tailored to each person with Multiple Sclerosis, to find what they enjoy and what they will be able to continue after the program. This means offering choice and considering community options, such as sessions in gyms, public pools, parks, or other environments that are engaging to you.
Physiotherapists can help you to find appropriate exercise techniques, as patients with Multiple Sclerosis are often at an increased risk of falling. Some considerations that need to be made before suggesting exercise are:
- whether you are safe for a group setting or would be more suited to 1-1 therapy; due to falls risk, if you are ready psychologically after a period away from exercise, if you have the endurance to tolerance a whole class,
- Types of appropriate exercise; again, considering your risk of falls and what supports are available in the setting or local club to allow you to exercise confidently
- Your own interests and goals!! – Do you want to improve your balance with exercise? Or your agility? Or reduced your falls? Or get more time out in the community?
- Would you need a carer or support worker with you to participate in the exercise long-term? This can definitely be arranged.
Tisara Pathiranage
References:
Morrison, E. H., Cooper, D. M., White, L. J., Larson, J., Leu, S. Y., Zaldivar, F., & Ng, A. V. (2008). Ratings of perceived exertion during aerobic exercise in multiple sclerosis. Archives of physical medicine and rehabilitation, 89(8), 1570-1574.
Nice.org. (2019). Multple Sclerosis in Adults: Management. Retreived from: https://www.nice.org.uk/guidance/cg186/chapter/1-Recommendations#ms-symptom-management-and-rehabilitation-2
Sutherland, G., Andersen, M. B., & Stoové, M. A. (2001). Can aerobic exercise training affect health-related quality of life for people with multiple sclerosis?. Journal of Sport and Exercise Psychology, 23(2), 122-135.
White, L. J., & Dressendorfer, R. H. (2004). Exercise and multiple sclerosis. Sports medicine, 34(15), 1077-1100.
