Exercise and Multiple Sclerosis

 How Does Exercise Help with MS?

Many of the symptoms associated with MS are reduced through physical activity or exercise. Exercise is a great way for everyone to stay strong, control weight, improve fitness, and prevent chronic diseases such as heart disease. While managing the consequences of MS, exercise represents a crucial tool and important approach for improving health and wellness. Unfortunately, inactivity can invite consequences such as fatigue, poor strength and poor fitness. If an individual is feeling fatigued, they might be less likely to exercise, and as a result, they can experience even more fatigue over time.

There is scientific evidence that exercise improves outcomes for persons with MS. These outcomes range from the cellular level to quality of life. Research has indicated that persons with MS who engage in exercise have better brain health, better cognition based on speed of information processing, and increased mobility and cardiovascular health. Plus, persons with MS who engage with exercise have less fatigue, depression, anxiety, and pain, and better sleep quality and quality of life.

Is Exercise Safe for People with MS?

Yes! Exercise can be just as safe for people with MS as it is for people without. Research that summarised the risk of relapse and other adverse events associated with exercise training for people with MS has shown that exercise is not associated with increased risk of relapse or risk of adverse events. However your exercise program should be tailored to your abilities, needs and goals.

What Type of Exercise is Best for People with MS?

To be effective, exercise should be performed regularly at a suitable intensity. Most importantly, choose exercise that you enjoy as you will be more likely to stick with it! The internationally recognised physical activity guidelines for adults with mild to moderate MS tell us how much physical activity people with MS are encouraged to participate in.

Physical activity guidelines for adults with mild to moderate MS are:

30 minutes of moderate intensity aerobic activity, two days per week; and strength training for major muscle groups, including the calf muscles, leg muscles, abdominal, and arm muscles, on two days per week. If you are beginning again with exercise, slowly work up to this volume of exercise over 2 to 3 months and seek the help of your exercise physiologist or physiotherapist. Break exercise into shorter bouts of 10 to 15 minutes at a time if necessary. For strength training exercise, slowly work up to doing two sets of 10-15 repetitions of each strength training exercise. Experiment with timing so that exercise does not tire you out for the rest of your day.

Aerobic exercise can be performed in a variety of settings including individual and group training sessions on land or in water. Walking is the number one choice of aerobic exercise by persons with MS, and walking intensity can be measured by counting your steps over a period of time (e.g. by using a pedometer or smart phone/watch). Use of exercise bikes and elliptical trainers is preferable to the use of a treadmill when there is a risk of tripping and falls.

Our advice is:

Start small and see how you go. i.e. think how fast/far can you already walk? Build this up to achieve your 30 minutes of aerobic exercise. Walking 100 steps in a minute is moderate intensity aerobic exercise for persons with MS. But remember, something is always better than nothing and don’t be disheartened if you’re not meeting the recommendations straight away.

References: Klaren RE, Motl RW, Dlugonski D, Sandroff BM, Pilutti LA. Objectively quantified physical activity in persons with multiple sclerosis. Arch Phys Med Rehabil. 2013;94(12):2342–8. Motl RW, Pilutti LA. The benefits of exercise training in multiple sclerosis. Nat Rev Neurol. 2012;8(9):487–97. Pilutti LA, Platta ME, Motl RW, Latimer-Cheung AE. The safety of exercise training in multiple sclerosis: a systematic review. J Neurol Sci. 2014;343(1–2):3–7. Moore G, Durstine JL, Painter P, Medicine AC of S. ACSM’s Exercise Management for Persons With Chronic Diseases and Disabilities, 4E. Human Kinetics; 2016. Latimer-Cheung AE, Pilutti LA, Hicks AL, Martin Ginis KA, Fenuta A, Mackibbon KA, et al. The effects of exercise training on fitness, mobility, fatigue, and health related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. Arch Phys Med Rehabil. 2013;94(9):1800–28.