Exercise is very important for patients with multiple sclerosis (MS). Recent studies show that exercise can yield real improvements in quality of life for patients. Studies also show that people with MS can exercise more than was believed possible even a decade ago. There are at least five ways exercise has a positive impact on the health of people with MS.

Muscle strength increases with exercise. Studies show that patients' performance of daily tasks improves with exercise. Walking pace and stair climbing ability, for example, are improved by exercise.

Fatigue is a common problem for patients with MS. The severe fatigue of MS can be improved by exercise. (See tips below).

Bowel and bladder function is enhanced by exercise. About 75 percent of patients have bladder problems. About 60 percent have bowel problems.

Depression is reduced by regular exercise. In studies with patients who have MS, exercise stimulated a more positive mental outlook. Patients who exercised also got involved in more social activities.

Contractures -- permanent muscle contracts -- can be reduced or prevented with exercise. In contractures, joints are "frozen" in either a flexed or extended position. A contracture occurs if opposing muscle groups become too weak to counteract the muscle contraction.

Before you begin exercising ask your doctor about what exercises are right for you. A physical therapist can help you design an exercise program.

Patients may experience worsening of symptoms if they get overheated during exercise. Here are some things patients can do to avoid overheating:

Choose exercises that are less likely to cause overheating, such as swimming in a non-heated pool.

Exercise in the early morning. Body temperature is naturally lower then.

Wear a cooling vest to keep body temperature down.

Before and after exercising, sit in a bathtub filled with cool water for at least 15 minutes.

People who exercise are usually healthier and happier than those who don't exercise. They are also more likely to live longer and to have a more positive outlook. For these reasons, exercise has now become an important part of the treatment plan.

Regular exercise, designed around a patient's physical abilities and limitations, yields many benefits:

Cardiovascular health improves. Regular exercise helps lower blood pressure. It also increases "good" cholesterol, improves circulation, and helps reduce the risk of heart disease.

Muscles around the joints get stronger. This reduces strain on the joints and helps protect them. Exercise also improves flexibility and reduces stiffness. Bones get stronger. Weight-bearing exercise applies tension to muscle and bone. Weight-bearing exercise can increase bone density by as much as 2 to 8 percent a year, helping to prevent osteoporosis.

Weight control gets a big boost from exercise. Keeping a normal weight helps to prevent health problems like heart disease and high blood pressure.

Stress is reduced by exercise. Exercise promotes relaxation and reduces tension. Over time, exercise increases the body's ability to deal with stress. Mental functions may be improved. Math skills, creativity, reaction time, imagination and other mental skills have been linked to aerobic exercise.

Depression and anxiety are decreased. Exercise prompts the release of endorphins, the body's natural "feel good" chemicals. Studies show that as fitness improves, endorphins are released faster during exercise.

The digestive tract benefits from exercise. Those who exercise often are less likely to have constipation, indigestion, or ulcers.

Other benefits include sleeping better at night, less fatigue, and more energy.

Exercise can be therapeutic or just for fun. A therapeutic exercise program is one designed to achieve specific health benefits for the patient. A physical therapist, occupational therapist, or physician can help patients design exercise programs that are right for them. A balanced program may include three kinds of exercise:

Stretching exercises preserve joint function and flexibility. They also help prevent muscle stiffness and cramps. Yoga and Tai Chi are stretching exercise regimens that focus on flexibility and balance. Range of motion exercises move joints as far as they can comfortably go, and then stretch just a little further. Some types of stretching exercises can be very good for the back.

Strength training exercises build muscle power. There are two kinds of strength building exercises: isotonic and isometric. Isotonic exercises involve moving the joints. They may use resistance, such as weights or moving against water. Isometric exercises contract the muscles without moving the joints. Both kinds of strength building exercise help reduce body fat. They also help lower "bad" cholesterol and aid digestion. Strength building exercises become more important as we grow older and lose muscle tissue.

Aerobic exercises build the stamina of the entire body and strengthen the heart and lungs. Dancing, bicycling, and walking are examples of aerobic exercises. Swimming does not raise the heart rate as high as other aerobic exercises, but it is ideal during pregnancy or for those with illnesses like MS. Aerobic exercise is also called endurance exercise.

1. Half of those who begin a workout routine abandon it within a year. For this reason, it is important to choose activities that you really enjoy. Walking has the lowest drop out rate. Alternating among a variety of activities can help prevent boredom.

2. If you have a chronic illness, consult your doctor before beginning any exercise program. For healthy people, the American Heart Association recommends at least 30 minutes of exercise three or more times a week. Ask your doctor if this is appropriate for you.

3. Before any endurance exercise, always warm up with stretching or range of motion exercises. To end the workout, transition into a cool down phase that lasts several minutes before completely stopping. This will help prevent stiffness and pain.

4. Stop exercising if you don't feel well. Sharp pain, shortness of breath, dizziness, a tightening in the chest, or nausea are "stop" signs. If muscles cramp, rub them and try a new position or technique. Get advice from a physical therapist or fitness expert if you need to re-evaluate your program.

References

First published December 1, 2000
Last updated May 5, 2003
Copyright © 2000 Accordant Health Services, Inc. All Rights Reserved.

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