 In Exercises for Multiple Sclerosis, the author aims to present a safe and effective programme to fight fatigue, build strength and improve balance.
The first four chapters give generalities about MS, drug treatment possibilities and the treatment of symptoms are described. Here, in these early chapters, I think there is a clear lack of the multidisciplinary approach to rehabilitation.
The following practical part of the book is about gait analysis, core/abdominal training and resistance training. The approach is a total body training starting with what the author calls the “largest muscles” and working down to the “smaller” ones. The exercises are well illustrated and explained and different exercises are given for the same muscle or muscle groups to avoid repetition in the training programme.
Another chapter describes a positive mental approach, in which the author proposes doing a mental workout. He suggests trying to visualise yourself doing the workout, and trying to feel the physical changes and efforts you would make while performing the exercises.
The exercise workload (for example the frequency, intensity, number of repetitions, how to define the starting weight) is not always clearly stated. However, the author proposes exercising three times a week and undertaking 20 to 30 repetitions for each muscle or muscle group with rest periods of 45 to 90 seconds between each exercise.
One positive aspect of the book is that the author writes about good and bad days in MS and the need to adapt the training programme and workload to those days by doing less or more.
However, one of the aims of the book is to manage fatigue, and while we all believe that people with MS can benefit from exercise, fatigue management needs to involve much more than just exercise.
It is clear that the professional background of the author is the field of fitness and that general fitness principles are applied to people with MS from the author’s own experiences. The book does point out correctly, however, that people with MS should get advice from an MS-specialised physiotherapist or rehabilitation specialist before undertaking an exercise programme.
Reviewed by Paul Van Asch, physiotherapist in sports and neurology, Manager of Fit Up Fitness Centre, Belgium.
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