Written by: Heidi Olynyk (Accredited Exercise Physiologist)
Understanding Multiple Sclerosis
Multiple Sclerosis (MS) is a chronic neurological disorder affecting the central nervous system causing the immune system to mistakenly attack the protective covering of nerve fibres causing neurodegeneration and inflammation.
This condition typically begins between the ages of 20-40, more commonly affecting women. This leads to a wide array of symptoms such as fatigue, muscle weakness, coordination difficulties, and cognitive impairment.
The role of exercise in managing MS is therefore critical and plays a pivotal role in managing symptoms and improving the overall quality of life for individuals living with this condition.
In this article, we will delve into the benefits of exercise for multiple sclerosis, exploring the physiological mechanisms behind its positive effects and providing practical insights into designing exercise programs tailored to MS patients.
Improved Cardiovascular Health
Engaging in regular cardiovascular exercise has numerous benefits for individuals with MS including improved cardiovascular fitness, mood, well-being, and respiratory functioning. This is particularly important for MS patients, as cardiovascular complications can arise due to the sedentary lifestyle often associated with the condition.
Aerobic exercise also helps combat fatigue, a prevalent symptom of MS. Research has shown that structured aerobic training can significantly reduce fatigue levels and improve overall energy levels in individuals with MS, thereby enhancing their ability to perform daily activities.
Enhanced Muscle Strength and Endurance
MS often leads to muscle weakness and atrophy, making daily tasks more challenging. The strength of the lower limbs is commonly more affected by MS progression more specifically the knee extensor and foot muscles impacting walking performance and movement capacity. Incorporating resistance exercise into a weekly routine to help build strength and endurance can enable individuals with MS to maintain or regain functional independence.
Improved Balance and Coordination
Balance and coordination deficits are common in individuals with MS, contributing to increased fall risk and injuries. Exercise programs that incorporate balance and coordination training can help mitigate these challenges. Research supports the effectiveness of balance training in individuals with MS.
A study published in the “International Journal of MS Care” demonstrated that a 12-week balance and coordination program led to significant improvements in postural control and reduced the fear of falling in individuals with MS.
Flexibility
Those with MS will often report having reduced movement through the joints due to spasticity and sedentary behaviour. The importance of incorporating flexibility training of the pelvis, chest, leg, and hip flexors into weekly exercise is to help lengthen muscles, improve joint range of motion, reduce spasticity, and help with posture.
Positive Impact on Mental Health
The psychological impact of MS should not be overlooked, as individuals with the condition often experience elevated levels of stress, anxiety, and depression. Regular exercise has been shown to have profound positive effects on mental health by reducing the symptoms.
NDIS and MS Australia’s Role with Multiple Sclerosis
NDIS is a National Disability Insurance Scheme currently providing support to over 250,000 Australians with more than 5500 of those individuals being impacted by MS. NDIS is working together with MS Australia which is Australia’s largest not-for-profit organisation providing support and services, information, and resources for those with MS. For more information visit their website msaustralia.org.au
NDIS and Exercise Physiology
Individuals with early-stage MS should consider early intervention support to help slow down disease progression.
The social support that comes with supervised exercise can be valuable for individuals with MS, offering a support network that understands and empathises with their challenges.
As Exercise Physiologists, we will support the needs of each individual and create an exercise program tailored specifically to them to help improve their health, well-being, and being able to stay independent.
Exercise represents a powerful and accessible intervention for individuals living with MS. By also addressing both physical and psychological aspects of the condition, exercise can contribute to improved cardiovascular health, enhanced muscle strength and endurance, better balance and coordination, neuroprotection, and positive mental health outcomes.
References
1. Motl, R. W., & Pilutti, L. A. (2012). The benefits of exercise training in multiple sclerosis. Nature Reviews Neurology, 8(9), 487-497.
2. Dalgas, U., Langeskov-Christensen, M., Skjerbæk, A., Jensen, E., & Nybo, L. (2019). Exercise as medicine in multiple sclerosis—time for a paradigm shift: Preventive, symptomatic, and disease-modifying aspects and perspectives. Current Neurology and Neuroscience Reports, 19(11), 88.
3. Manto, M. U., Hampe, C. S., & Rogemond, V. (2016). Neurological effects of vitamin B12 deficiency and its relevance to multiple sclerosis. BioMed Research International, 2015.
4. Pilutti, L. A., Platta, M. E., Motl, R. W., Latimer-Cheung, A. E., & The Canadian Physical Activity Guidelines for Adults with Multiple Sclerosis Research Team. (2014). The safety of exercise training in multiple sclerosis: A systematic review. Journal of the Neurological Sciences, 343(1-2), 3-7.
5. Sá, M. J. (2015). Exercise therapy and multiple sclerosis: A systematic review. Journal of Neurology, 262(10), 2693-2701.
6. Kalron, A., & Achiron, A. (2017). Postural control, falls and fear of falling in people with multiple sclerosis without mobility aids. Journal of Neurology, 264(6), 1089-1093.
7. Platta, M. E., Ensari, I., Motl, R. W., & Pilutti, L. A. (2015). Effect of exercise training on fitness in multiple sclerosis: A meta-analysis. Archives of Physical Medicine and Rehabilitation, 96(8), 1557-1566.
8. Briken, S., Gold, S. M., Patra, S., Vettorazzi, E., Harbs, D., Tallner, A., … & Heesen, C. (2014). Effects of exercise on fitness and cognition in progressive MS: a randomized, controlled pilot trial. Multiple Sclerosis Journal, 20(3), 382-390