If you want to keep active with MS, here is a roundup of some of the different types of exercise you can try, and the ways they can benefit you.
In the past, people with multiple sclerosis were advised to avoid exertion. It was felt that since many people with MS experienced fatigue and found their symptoms worsened when hot, it was best to avoid activities that could be seen as tiring.
It turns out that this was not good advice. Regular, moderate exercise is now known to be an important part of maintaining good health and wellbeing for people with MS. There is evidence that it can help with many MS symptoms, and also with general quality of life.
How can exercise help with my MS symptoms?
There have been many studies to look at the benefits of different kinds of exercise for people with MS. It can be hard to compare these studies, but they have in general shown exercise to be valuable for people with MS.
Moderate exercise has been shown to improve strength, mobility and bowel and bladder function for people with mild to moderate MS. Exercise is also helpful in helping maintain a healthy weight. This reduces your chances of acquiring co-morbidities, and can also reduce the impact of some MS symptoms, such as pain and fatigue.
Exercising is good for the mind and brain, not just the body. In general, exercise has been found to be neuroprotective, to improve symptoms of depression, improve cognitive processing speed, visuospatial memory, executive function and cognitive flexibility. These boosts can last for several days after exercising.
Aerobic exercises are dynamic exercises where you raise your heart rate by moving quickly. This might mean running, dancing or playing a team sport like football or netball.
Aerobic exercise is particularly good for cardiovascular health. Moderate intensity aerobic exercise has been shown to quickly improve the blood pressure and proportion of healthy fats in the blood. It also reduces the amount of fat stored in the body, and can help with weight loss.
Depending on the type of exercise, aerobic activity has been shown to improve the aerobic capacity, functional mobility, visuospatial memory, brain volume, fatigue, and quality of life of people with MS.
Dynamic workouts lead to improvements in balance and co-ordination. There can be further benefits in that the deeper breathing that you do with this kind of activity can also strengthen your core muscles and posture. Aerobic exercise improves walking ability, particularly in conjuction with resistance training to strengthen the legs.
High Intensity Interval Training, or HIIT, involves aerobic training in very short bursts, and has been shown to be as effective in fitness and weight loss as other aerobic exercising. The theory is that you exercise as hard as you can for four four minutes, take a short break and repeat several times, focusing on a different exercise each time. For people with MS, exercising in short bursts may help to avoid overheating. Shorter workouts are also easier to fit into busy lives.
Try to maintain regular aerobic activity, as the positive benefits reduce soon after you cease exercising.
Also known as progressive resistance training, strength training might involve exercises where you lift weights, use your body weight to work against (such as sit-ups or push-ups), or pull against an elastic band. The aim is to build and strengthen your muscles.
Moderate strength training exercise helps with balance and posture, and also helps combat fatigue. Muscles that are not used regularly become weakened and then require more energy to carry out tasks. This can lead to a cycle of decline, as an already weak muscle that is not used will become weakened further, a process known as atrophy.
Strength training improves general fatigue, cognitive fatigue, and also increases the connectivity between brain regions in people with MS. It is thought that increased brain connectivity may protect against fatigue and future cognitive decline.
The positive effects of resistance training last for several weeks after stopping.
Endurance training is training the aerobic system, improving your cardiovascular resilience and also making muscles more efficient. It would involve regular, steady aerobic exercise, such as cycling, swimming or jogging. You would typically start with shorter distances and time spent exercising, and build up to longer periods of exercise.
Over time, endurance training improves your ability to recover from exertion, although care must be taken not to over-exert yourself too quickly.
Endurance training has been shown to provide benefits in walking ability in people with MS. When people with MS were studied doing a combination of endurance training with leg resistance training they found improvements in mobility, balance and co-ordination.
As with other forms of exercise, stopping endurance training generally results in the benefit being lost over time.
- Annals of Neurology 1996;39:432-441. Summary Impact of aerobic training on fitness and quality of life in multiple sclerosis.
- Neuropsychol Rehabil. 2018 Apr 4:1-13 Summary Progressive resistance exercise training and changes in resting-state functional connectivity of the caudate in persons with multiple sclerosis and severe fatigue: A proof-of-concept study.
- Transl Behav Med. 2018 Mar 27 Summary Activity matters: a web-based resource to enable people with multiple sclerosis to become more active.
- Pediatric Health Med Ther. 2018 Mar 6;9:17-25 Full article Pediatric multiple sclerosis: current perspectives on health behaviors.
- Neuropsychiatr Dis Treat. 2010; 6: 767–774. Full article Exercise Training and Cognitive Rehabilitation: A Symbiotic Approach for Rehabilitating Walking and Cognitive Functions in Multiple Sclerosis?
- Multiple Sclerosis Journal. 2017 Nov 1 Summary Effects of an individual 12-week community-located "start-to-run" program on physical capacity, walking, fatigue, cognitive function, brain volumes, and structures in persons with multiple sclerosis.
- Int J Mol Sci. 2018 Jan 8;19(1). Twelve Weeks of Medium-Intensity Exercise Therapy Affects the Lipoprotein Profile of Multiple Sclerosis Patients.
- Journal of Neurology 2018 Mar 24 Summary Fatigue, as measured using the Modified Fatigue Impact Scale, is a predictor of processing speed improvement induced by exercise in patients with multiple sclerosis: data from a randomized controlled trial.
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