Exercise and Multiple Sclerosis

Abstract

The pathophysiology of multiple sclerosis (MS) is characterised by fatigue, motor weakness, spasticity, poor balance, heat sensitivity and mental depression. Also, MS symptoms may lead to physical inactivity associated with the development of secondary diseases. Persons with MS are thus challenged by their disability when attempting to pursue an active lifestyle compatible with health-related fitness. Although exercise prescription is gaining favour as a therapeutic strategy to minimise the loss of functional capacity in chronic diseases, it remains under-utilised as an intervention strategy in the MS population. However, a growing number of studies indicate that exercise in patients with mild-to-moderate MS provides similar fitness and psychological benefits as it does in healthy controls. We reviewed numerous studies describing the responses of selected MS patients to acute and chronic exercise compared with healthy controls. All training studies reported positive outcomes that outweighed potential adverse effects of the exercise intervention. Based on our review, this article highlights the role of exercise prescription in the multidisciplinary approach to MS disease management for improving and maintaining functional capacity. Despite the often unpredictable clinical course of MS, exercise programmes designed to increase cardiorespiratory fitness, muscle strength and mobility provide benefits that enhance lifestyle activity and quality of life while reducing risk of secondary disorders. Recommendations for the evaluation of cardiorespiratory fitness, muscle performance and flexibility are presented as well as basic guidelines for individualised exercise testing and training in MS. Special considerations for exercise, including medical management concerns, programme modifications and supervision, in the MS population are discussed.

Aerobic Exercise in People with Multiple Sclerosis

“…Further, exercise progression was well tolerated, as demonstrated by an increased workload for a longer duration with a lower overall rate of perceived exertion. Based on this finding, the least recommended dose of aerobic exercise 21 (frequency, twice per week; duration, two consecutive sessions of up to 15 minutes each; intensity, 50% to 70% of peak oxygen consumption per unit exercise may benefit individuals with MS. Furthermore, in our study, BDI-II Somato-Affective subscale scores remained improved after the 3-month period of unstructured physical activity.…”

“…To set the initial aerobic exercise intensity, we assessed cardiovascular function by continuously monitoring each participant's breath by breath gas analysis via a telemetry metabolic measurement system (MedGraphics VO 2000 ; MGC Diagnostics, St. Paul, MN) while performing the 6-Minute Walk (6MW) test according to American Thoracic Society guidelines. 8 Test order was standard- The initial target exercise training intensity on the UE/ LE ergometer and treadmill was set at 50% to 70% of oxygen consumption achieved 21 as established by the 6MW during session 1. We conducted aerobic testing to set an appropriate exercise goal and to monitor safety of the participants during exercise.…”

Physical Activity Levels in People with Multiple Sclerosis in Saskatchewan

“…21,22 Some specific exercise guidelines for the MS population have been proposed. 1,12,23 In a comprehensive review of exercise and MS, White and Dressendorfer 1 suggested moderate aerobic exercise for a total of 20 to 30 minutes, alternating with rest periods, two to three times per week. Daily general flexibility exercises were also recommended.…”

Effects of aquatic exercises in a rat model of brainstem demyelination with ethidium bromide on the beam walking test

“…In general, group 1 animals (demyelinated + exercise) had fewer errors when compared to group 2 (demyelinated + sedentary). In clinical studies, physical exercise practice by individuals with Ms has greatly benefited such patients [18][19][20] . one study showed that different types of exercise, including aquatic exercises, for Ms individuals with mild to moderate compromise lead to improved functional activities, execution of daily life activities, as well as decreased fatigue and improved quality of life of such individuals 20 .…”

“…In clinical studies, physical exercise practice by individuals with Ms has greatly benefited such patients [18][19][20] . one study showed that different types of exercise, including aquatic exercises, for Ms individuals with mild to moderate compromise lead to improved functional activities, execution of daily life activities, as well as decreased fatigue and improved quality of life of such individuals 20 . some aspects of the physical properties of water, such as buoyancy and viscosity, diminish the action of gravity and allow greater balance, movement amplitude, development of muscle strength and endurance, all contributing to improvement in symptomatology and functional deficits.…”