MS and Exercise

Canadian researchers hope an exercise routine designed for those with multiple sclerosis (MS) will show increased benefits over traditional guidelines. In their upcoming study, which is currently accepting volunteers, investigators will follow MS patients as they engage in a specially designed “Multiple Sclerosis Tailored Exercise Program” (MSTEP).

These volunteers will be compared to another group who exercise according to current clinical guidelines. The investigators won’t know who is assigned to which exercise group. According to the study design, the researchers will examine the effects of MSTEP on the exercise capabilities of people with MS who live sedentary lives and would like to add exercise to their MS self-management routine.

The study, which will enroll 240 patients, is built on earlier research showing that MS patients with even mild disability, as measured using the Expanded Disability Status Scale (EDSS), have a greatly reduced capacity for exercise. Compared to a healthy control group, those with minimal MS disability did not perform as well at push-ups, curl-ups, or even demonstrating grip strength.

Fatigue: A Vicious Cycle

According to the National Multiple Sclerosis Society (NMSS), “Fatigue is one of the most common symptoms of MS, occurring in about 80 percent of people. Fatigue can significantly interfere with a person's ability to function at home and at work and may be the most prominent symptom in a person who otherwise has minimal activity limitations. Fatigue is one of the primary causes of early departure from the workforce.”

It’s difficult to exercise if you suffer from debilitating fatigue. However, exercise has been proven to reduce fatigue in some MS patients.

In years past, exercise was believed to be detrimental for those with MS. After Wilhelm Uhthoff’s discovery in 1890 that increased body temperature resulted in a temporary rise in MS symptoms, patients were often instructed to avoid physical activity because it might worsen their MS.

In a 2002 study, Swiss researches proved that assumption wrong, concluding that heat sensitivity shouldn't prevent MS subjects from engaging in regular exercise and physical activity. The study showed that those who exercised experienced a reduction in fatigue, an improvement in fitness and activity levels, and a higher perception of their health status.

Physical Activity Impacts Quality of Life

In a survey regarding physical activity, conducted in part by researchers at the University of Wisconsin, 215 patients were recruited from the NMSS to fill out questionnaires about their readiness to engage in physical activity as well as their health-related quality of life.

"Exercise was not only found to be a partial mediator but also a moderator between functional disability and health-related quality of life. Exercise had a stronger effect on health-related quality of life for individuals with lower functional disability than people with higher functional disability," said Connie Sung, Ph.D., an assistant professor at Michigan State University.

The most important takeaway from the study, Sung added in an interview with Healthline, is that “Health-promoting behaviors, including regular exercise, are important for health-related quality of life, [which] in turn is related to better employment outcomes. Rehabilitation professionals should consider including health promotion interventions in vocational rehabilitation services for individuals with MS.”

Get Moving!

For people with MS who have been living a sedentary lifestyle, switching gears and becoming more active is best done gradually.

“The first step is always to talk to a health care provider who is knowledgeable about MS and physical fitness to determine what type of exercise is best for your physical condition,” said Megan Weigel, DNP, a nurse practitioner and MS Certified Nurse at Baptist Medical Center in Jacksonville, Fla. in an interview with Healthline.

“When you start out on a new exercise program, plan to exercise during your best time of day,” Weigel advises. “Be sure to stay cool and hydrated. Start slow, ease in, and reward yourself for progress!”

So what type of exercise is best? “Since everyone with MS has different symptoms, there are no specific exercises for MS,” Weigel says. “Also, types of recommended exercises vary based on physical fitness level and other medical conditions. I definitely recommend yoga and tai chi for all types of MS as they are beneficial for balance and anxiety.” Perhaps the upcoming Canadian study will demonstrate that MSTEP is also a viable option.

But what if you can’t get motivated? “Group exercise classes can be fun, and many people find it easier to exercise with a buddy to hold themselves accountable," Weigel says. "Adding exercise to your life with MS is an excellent and recommended lifestyle change.”

No Downside to Exercise

Even if this forthcoming study fails to prove that an exercise routine designed for MS is better than traditional recommendations, regular exercise is still a healthy choice.

“Engaging in physical activity is of the utmost importance to break the cycle of inactivity, low level of functioning, and higher level of disability,” stresses Sung. “Although encouraging exercise and physical activity is potentially challenging given mobility issues associated with MS, possible options include developing self-efficacy, focusing on an enjoyable experience, establishing an environment in which people feel comfortable, and developing social support both in and out of the physical activity environment.”

While becoming more physically active is a positive first step, sticking to your fitness plan is key. Sung cautions that, “Individuals with MS who are already engaging in exercise and physical activity still must address their intentions to continue a regular exercise program.”

For more information about how you can take part in the exercise and MS trial, contact carolina.moriello@mcgill.ca.

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