Exercise and Multiple Sclerosis (MS)

For those who have been diagnosed with Multiple Sclerosis (MS), understanding what you can and cannot do is often challenging. MS is thought to be an autoimmune disease and is described as a progressive demyelinating disease of the white matter of the central nervous system. This means that the body’s own defense system attacks the substance that surrounds and protects the nerve fibers in the body. Plus, the nerve fibers themselves can also be damaged. Scar tissue is formed and nerve impulses traveling throughout the body are distorted. Since nerve impulses are the means by which our bodies communicate with themselves, this can cause a wide variety of symptoms and each person’s experience with MS can be quite different. Some of the clinical features commonly associated with MS are general fatigue and muscular weakness, as well as spasticity, ataxia, sensory disturbances, and cognitive dysfunction. 1,2

In the last 15 years, there has been quite a bit of activity and progress in the pharmacological arena. Although there is still no cure, numerous drugs have been and will continue to be tested for all stages of MS. However, it is important to take a look at what else can be done to improve the quality of life of patients diagnosed with MS. According to information provided by the National Multiple Sclerosis Society, there are many effective strategies available to modify the disease course, treat flare-ups, manage symptoms, and improve function and safety. One of the more commonly suggested strategies is to exercise. Exercise has been shown in numerous research studies to significantly improve the quality of life in MS patients. One such study took a look at how structured exercise affected MS patients both physically and psychologically. Considerable improvements were found in those who exercised when compared to a control group. Depression, anger, and fatigue were reduced while social activity, emotional behavior, and recreational pursuits increased. 3 In fact, excessive fatigue is commonly mentioned as one of the most frequent symptoms of MS patients and has been shown to be significantly reduced by controlled exercise.

What does all of this mean? Well, it means that if you have been diagnosed with MS, it is recommended and even encouraged that you exercise. Exercise can be a vital component of your treatment strategy. However, take it slow! Don’t overdo it. Progress yourself a little bit at a time. Pushing yourself to your limits or beyond them can have the opposite effect from what you desire. Remember, your nervous and muscular systems are already strained.

Before you begin an exercise program, check with your doctor to see if he or she has any recommendations for you. You may find that there are certain types of exercise that you should avoid. However, for many MS patients there are typically a wide variety of types of exercises that can be done such as light strength training, cardiovascular exercise, Pilates, balance training, swimming, Gyrokinesis, and even some basic yoga.

Some things to consider when planning your exercise are:

•  Prepare your environment. Whether you choose to exercise at home or in a public setting, make certain that your surroundings are safe and not distracting. Remove objects that you could trip over or surfaces that you could slip on. Ensure adequate lighting and avoid blaring music.

• Consider exercising with a friend or family member that understands MS and what challenges it represents to you. Plus, they could help to motivate you to stay consistent with your exercise program.

• Begin with a short-duration workout and add to it a little bit each week.

• Always warm-up before beginning exercise and cool-down when finished. Warming up prepares your body for exercise and helps to prevent injuries.

• Stop if you begin to feel sick or experience pain.

• Consult a Certified Fitness Professional that is experienced in working with those who have been diagnosed with MS. An understanding, qualified Fitness Professional can help you put together a program that is right for you.

Another important point to mention is that MS can often cause sensitivity to heat. Of course, an increase in body temperature occurs during exercise, thus try to be careful not to overheat. Some common recommendations include exercising during the cooler parts of the day, drinking plenty of cool fluids, and wearing cool and loose fitting clothing. If you are exercising indoors, try to have fans available to create some air movement. In the event that you feel disoriented or experience increased symptoms, stop exercising and allow yourself to cool down.

Keep in mind, if you have been diagnosed with Multiple Sclerosis, exercise can play a large role in maintaining the quality of life that you desire. MS affects the nervous system and exercise has been proven time and again to have a positive impact on the nervous system. When you are ready to start an exercise program, I highly recommend contacting your physician right away to inform them of your intentions. Once you have clearance from your physician, contact a qualified Fitness Professional to begin putting together a program that suits your needs. Lastly, relax and have fun with it!


References
1. Kesselring J. Multiple sclerosis. Cambridge Univ. Press, UK, 1997.

2. Krupp LB, Alvarez LA, La Rocca NG, Scheinberg LC. Fatigue in multiple sclerosis. Arch Neurol 1988; 45: 435-37.

3. Petajan JH, Gappmaier E, White AT, et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 1996; 39: 432-441.