Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations

Abstract

BackgroundMultiple sclerosis (MS) can result in significant mental and physical symptoms, specially muscle weakness, abnormal walking mechanics, balance problems, spasticity, fatigue, cognitive impairment and depression. Patients with MS frequently decrease physical activity due to the fear from worsening the symptoms and this can result in reconditioning.Physicians now believe that regular exercise training is a potential solution for limiting the reconditioning process and achieving an optimal level of patient activities, functions and many physical and mental symptoms without any concern about triggering the onset or exacerbation of disease symptoms or relapse.Main bodyAppropriate exercise can cause noteworthy and important improvements in different areas of cardio respiratory fitness (Aerobic fitness), muscle strength, flexibility, balance, fatigue, cognition, quality of life and respiratory function in MS patients.Aerobic exercise training with low to moderate intensity can result in the improvement of aerobic fitness and reduction of fatigue in MS patients affected by mild or moderate disability.MS patients can positively adapt to resistance training which may result in improved fatigue and ambulation.Flexibility exercises such as stretching the muscles may diminish spasticity and prevent future painful contractions. Balance exercises have beneficial effects on fall rates and better balance.Some general guidelines exist for exercise recommendation in the MS population.The individualized exercise program should be designed to address a patient’s chief complaint, improve strength, endurance, balance, coordination, fatigue and so on.An exercise staircase model has been proposed for exercise prescription and progression for a broad spectrum of MS patients.ConclusionExercise should be considered as a safe and effective means of rehabilitation in MS patients. Existing evidence shows that a supervised and individualized exercise program may improve fitness, functional capacity and quality of life as well as modifiable impairments in MS patients.

The effectiveness of whole-body cryotherapy and physical exercises on the psychological well-being of patients with multiple sclerosis: A comparative analysis

“…Physical exercise training is often used in the management of MS. Studies have shown that properly prescribed exercise programs can improve modifiable impairments in MS. 5 Exercise is generally safe and well-tolerated. 6 Whole-body cryotherapy (WBC) can support and complement primary treatment and facilitate physical activity. 7 In recent years, the use of WBC has gained recognition as a treatment option.…”

Multiple Sclerosis – A Physiotherapeutic Challenge

“…Appropriate exercise can lead to important improvements in different areas of cardiorespiratory fitness (aerobic fitness), muscle strength, flexibility, balance, fatigue resistance, cognition, quality of life and respiratory function in MS patients (Halabchi, Alizadeh, Sahraian, & Abolhasani, 2017). Some general guidelines exist for exercise in MS patients.…”

The Relationships between Physical Activity, Self-Efficacy, and Quality of Life in People with Multiple Sclerosis

“…and is rated on a 5-point Likert scale from 0 (Not at all confident) to 4 (Very confident). The items provide two sub-scores "Goal setting" (item 2, 3,4,5,6,7,8,13,14) and "Symptom management" (item 1,9,10,11,12,15). According to the authors [37], the scale is characterized by good item functioning, measurement invariance, and good concurrent validity (positive correlations with positive affect, sense of coherence and coping strategies and negative correlations with depression and negative affect).…”

“…Participation in Physical Activity (PA), particularly exercise training, represents the single most effective non-pharmacological approach for managing symptoms and improving the health-related quality of life (HRQoL) of people with MS [4][5][6]. However, people with MS do less PA compared to non-diseased people [7][8][9], but in similar way as other people suffering from a chronic disease [7].…”