There is a great deal of valuable information available on exercise. This article provides an overview of the major forms of exercise practised by people with MS, compiled from various sources. Sources are noted for the reader who would like further information.
Exercise is essential to general health and well-being and can also be helpful in managing many MS symptoms. An important study published by researchers in the United States in 1996 demonstrated the benefits of exercise for people with MS, including improved cardiovascular fitness, improved strength, better bladder and bowel function, less fatigue and depression, a more positive attitude and increased participation in social activities.
While exercising has many health benefits, not exercising poses risks for people with or without MS, including heart disease, muscle weakness, joint stiffness, decreased bone density with an increased risk of fracture, and shallow, inefficient breathing.
A physiotherapist experienced in MS can be helpful in designing, supervising, and revising a well-balanced exercise programme. With some guidelines, a good programme can help to develop the maximum potential of muscle, bone, and respiration, thereby avoiding secondary complications and gaining the benefits of good health and well-being. Any person with MS who is starting on a new exercise programme should consult an appropriate healthcare professional beforehand. (Source: The MS Information Sourcebook, National MS Society, April 2003)
Strengthening, stretching and range of motion
Strengthening exercises help make the body stronger and work on the principle of resistance, which requires the muscles to work progressively harder. Resistance is achieved through using exercise machines, elastic bands or weights. These types of exercises can be focused on specific muscle groups that have been weakened by disuse. It is important to consult a physiotherapist before beginning any strengthening programme, since there can be a risk of worsening spasticity.
The movement of joints may be impaired due to tightness of the joint capsule, ligaments and tendons. If a joint is not used regularly it will become stiff and will eventually interfere with normal movement. The objective of range of motion exercises is to maintain joint flexibility. This is achieved by moving each joint throughout the full range of movement.
Stretching exercises are recommended for muscles and tendons that have lost their elasticity, resulting in feeling stiff and having difficulty moving. These types of exercises are often helpful in preventing contractures, which is a “freezing” of a joint so that it cannot bend through its full range of motion. (Source: Multiple Sclerosis: The questions you have, the answers you need, 3rd Edition, RC Kalb. Demos Medical Publishing, 2004)
Aerobic exercise
Aerobic activity is any sustained, rhythmic activity that is able to raise the pulse and breathing rate. Some examples of aerobic exercise include swimming and cycling (with foot pedals or hand cycling). It is important to be consistent in following an aerobic exercise programme, with the recommended amount of time being 30 minutes, three to five times weekly. This may seem like quite a bit of exercise, especially for someone with mobility difficulties or MS fatigue. The 30 minutes can be broken down into shorter periods of time, although it is most effective, for cardiovascular fitness, to maintain an increased heart rate for a minimum of 20 minutes, at least three times weekly.
Yoga
Yoga is an Indian form of exercise, which, in traditional practice, aims to achieve complete awareness and tranquillity through certain physical and mental exercises. Yoga involves concentrated breathing and a range of stretches that revolve around the spine, increasing the body’s flexibility and releasing tension. Some of the movements may be easy for a person with MS while others may need practice or adaptation. (Source: The Multiple Sclerosis Resource Guide, http://www.msresourcenetwork.org)
A recently published study from the United States found that, similarly to aerobic exercise, people with MS participating in a weekly yoga class along with home practice, had improved levels of energy and decreased fatigue. While yoga and aerobic exercise have many similar properties, yoga has particular benefits for people with MS in that it has a stress reduction or relaxation component and it can also improve balance. (Source: Yoga Matters: Exercise for MS by C. Haran http://www.understandingms.com)
Tai chi
Tai chi is a Chinese martial art of Buddhist tradition that, as a conditioning regimen, is gentler than most forms of yoga and can be performed seated. Tai chi is usually performed as an ordered set of slow, elegant motions that promote balance through thoughtful consideration of movement and heightened body awareness. The movements focus on proprioception, which is one’s perception of movement and spatial orientation. This concept is especially important for people with MS who often experience difficulties with touch and balance. (Source: InsideMS, National MS Society, Volume 21, July-September 2003)
Aquatic exercise
Aquatic exercise or exercise in water is often recommended because it provides optimal exercise conditions for the person with MS. Water reduces the effects of gravity, and the weightlessness that occurs in water helps a person with weakened limbs attain a greater range of motion. In addition, chest-high water can provide support, enabling many people with MS to stand and maintain balance for exercises with less effort than normally required. The resistance that water provides can be used to strengthen muscles. Water also helps reduce the body heat that can be generated by exercise. Because the core temperature of the body remains lower, there is less over-heating, which is often a cause of temporary worsening of MS symptoms. Water temperatures of 80-84°F (27-29°C) are usually recommended. (Source: The MS Information Sourcebook, National MS Society, March 2003)
Conclusion
A person with MS has many fitness and exercise options and the choice will depend on one’s lifestyle, physical functioning, and the availability of suitable facilities. The key is deciding, together with a physiotherapist or other healthcare professional, the most appropriate form of exercise, and then getting started.
Benefits of Flexibility
• Enhanced physical fitness
• Improved ability to learn and perform skilled movements
• Increased mental and physical relaxation
• Development of body awareness
• Reduced muscular soreness
• Reduced muscular tension
• Decreased stiffness
(Adapted and reprinted with permission of the Multiple Sclerosis Society of Canada from Everybody Stretch: A physical activity workbook for people with various levels of multiple sclerosis, 2003)
Since MS symptoms can worsen with heat, aerobic exercise that is too vigorous may put a person at risk. Here are some tips for keeping cool while exercising:
• Exercise in a cool environment
(air-conditioning, fans)
• Exercise in a swimming pool with a temperature of 80-84°F (27-29°C)
• Drink cold fluids to be well hydrated and to lower body temperature
• Use a cooling vest, cap or neck pad while exercising
• Sit in a cool bath before exercise
• Wear light clothing
• Wipe down skin during exercise
• Maintain a moderate pace
(Adapted and reprinted from: Keeping Active When You Have MS, MS Society of Great Britain and Northern Ireland, 2003)
|
