What is Multiple Sclerosis (MS)?
A disease where the body's immune system mistakenly attacks myelin, the protective covering of nerve fibers, which disrupts the transmission of nerve impulses. Signs and symptoms of MS can vary and include, but are not limited to: fatigue, numbness, vision problems, and difficulty with balance and mobility.
A disease where the body's immune system mistakenly attacks myelin, the protective covering of nerve fibers, which disrupts the transmission of nerve impulses. Signs and symptoms of MS can vary and include, but are not limited to: fatigue, numbness, vision problems, and difficulty with balance and mobility.
Types of MS
1. Relapsing-remitting:
This is the most common type of MS. Relapsing-remitting MS is characterized by clearly defined attacks (relapses) followed by complete or partial recovery (remissions). This accounts for 75% of initial diagnoses.
2. Primary progressive:
This type of MS is characterized by progressive deterioration with only occasional plateaus and temporary minor improvements. This accounts for 15% of initial diagnoses.
3. Secondary progressive:
About half of people with relapsing-remitting MS experience an increase in symptoms within 10 years of diagnosis, with possibility of increasing levels of disability. This type of MS is usually preceded by relapsing-remitting MS.
4. Relapsing progressive:
This type of MS is characterized by progressive disease from onset, with acute relapses. There may or may not be full recovery periods between relapses with this type of MS.
Exercise and MS: What Does the Evidence Suggest?
There is solid research that exercise is protective for MS. However, exercise routine may look slightly different in people with MS due to their specific signs and symptoms, and it is important that the aforementioned be accounted for.
Exercise can help decrease the decline of cognition and increase quality of life and independence. It can also help prevent secondary complications such as cardiovascular disease and even type 2 diabetes.
1. Relapsing-remitting:
This is the most common type of MS. Relapsing-remitting MS is characterized by clearly defined attacks (relapses) followed by complete or partial recovery (remissions). This accounts for 75% of initial diagnoses.
2. Primary progressive:
This type of MS is characterized by progressive deterioration with only occasional plateaus and temporary minor improvements. This accounts for 15% of initial diagnoses.
3. Secondary progressive:
About half of people with relapsing-remitting MS experience an increase in symptoms within 10 years of diagnosis, with possibility of increasing levels of disability. This type of MS is usually preceded by relapsing-remitting MS.
4. Relapsing progressive:
This type of MS is characterized by progressive disease from onset, with acute relapses. There may or may not be full recovery periods between relapses with this type of MS.
Exercise and MS: What Does the Evidence Suggest?
There is solid research that exercise is protective for MS. However, exercise routine may look slightly different in people with MS due to their specific signs and symptoms, and it is important that the aforementioned be accounted for.
Exercise can help decrease the decline of cognition and increase quality of life and independence. It can also help prevent secondary complications such as cardiovascular disease and even type 2 diabetes.
Types of Exercises Beneficial for MS
Strength Training
Endurance Training
Aquatic Training
- Strength training is exercise that involves working against an external resistance.
- It is recommended that strength training be performed as follows:
- 1-3 sets, 10-15 reps, 2-3 nonconsecutive days/week
- Rest 1-2 minutes between each set and exercise
- Examples of strength training include: weight machines, free weights, cable pulleys, elastic resistance bands, aquatic exercises, and even body weight exercises!
- Functional strengthening: exercises that can help you complete your day to day activities such as getting out of bed, picking objects up off the ground, and climbing stairs.
- Exercise examples such as: step ups, forward lunge, and squats.
- Exercise examples such as: step ups, forward lunge, and squats.
- Chair exercises are also a great option for people with MS who struggle with walking, balance, and even for people who struggle with fatigue. It is very important that individuals who are exercising feel safe and comfortable. Chair exercises also help with conserving energy and preventing excessive fatigue.
Endurance Training
- Endurance training is exercise that involves light intensity, repetitive movements over time. This helps improve the efficiency of the heart and lungs in addition to the muscles.
- It is recommended that endurance training be performed as follows:
- 3x/week, at least 30 minutes. Minutes can be accumulated throughout the day. Try to do exercises in 10 minute bouts if you are easily fatigued.
- Examples include: stationary cycling, walking, and water aerobics as mentioned above.
- Walking: treadmill walking was superior to strength training in improving walking for individuals with MS- the more you do it, the better it gets! Walking is also shown to have a strong effect on cognitive performance in those with MS.
- Children and Adolescents: running/jogging was linked to smaller brain lesions and a lower relapse rate, suggesting that strenuous activity can potentially be protective in youth with MS
Aquatic Training
- Overheating is a common and often debilitating symptom for people with MS.
- Swimming allows efficient heat transfer from the body to the water.
- High body temperature can exacerbate symptoms (can’t lift legs, can’t perform ADLs, etc.).
- For those prone to falls, being in the water lowers the risk of falls and fractures.
- Studies show improvements in pain, fatigue, spasms and depression during aquatic training.
- Aquatic programs can be a great option for people with MS as the resistance of water helps strengthen muscles, while the cooling effect of water helps to decrease heat sensitivity that often triggers fatigue in people with MS. This type of program also helps with endurance as it is a light resistance usually more repetitive in nature.
- Chest-high water enables standing to maintain balance for exercises (less effort than on land); allows great joint range of motion.
Weight Bearing (standing)
- Standing shows improvements in movement, reduced muscle stiffness, better bladder and bowel function, and improved mental well-being in those with MS.
- Standing is thought to help by activating muscles against gravity, maintaining or enhancing flexibility in muscles and joints, influencing the nervous system to reduce spasticity, decreasing spasms, and providing a positive psychological boost.
- Stand often throughout the day however it is safe for you to do so- this may include using the counter or your gait aid.
Self-Management Tips
- Exercise
- Best to do exercises earlier in the day due to fatigue increases as day progresses.
- Make a “To Do” list of your weekly priorities and aim to spread them out.
- Pain management
- Did you know that the brain cannot differentiate between physical and mental pain?
- Because of this, sometimes our physical pain can increase when we are experiencing distressful situations.
- Stress management may reduce exacerbations of the disease symptoms.This may include breathing exercises.
- Rest
- Resting throughout the day and pacing tasks can have an improvement on quality of life.
- Sleep
- Having consistent bed and wake times helps regulate our internal clock and stabilizes energy levels.
- Arrange home and work surroundings to make it convenient
- Keep objects you use frequently in easy-to-reach areas. Keep items you use daily on the same floor. Avoid tripping hazards such as loose cords and flimsy rugs.
- Mobility aids
- Talk to your doctor, physiotherapist, or occupational therapist about which gait aids and assistive devices are best for you.
- Nutrition
- There are no special diets proven to prevent MS or affect the way it develops.
- However, eating healthy is still extremely important. Stick to the Canadian Food Guide and follow general guidelines such as:
- Reduce sugary foods
- Add protein to meals or snacks, or complex carbs such as whole grain bread to keep energy levels up
- Hydration
- Drink 6-8 cups (1.5L) water/day
- Avoid drinking too much caffeine
- Medications
- People with MS should follow the instructions of their doctor when it comes to medical management of their MS.
- Health Journal
- Keep track of the foods you eat, the exercises you’ve done, and how you feel throughout the day. You may recognize patterns of what works and does not work for you.
Questions?
If you ever have a question, never hesitate to reach out - it's why we are here!
If you ever have a question, never hesitate to reach out - it's why we are here!
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