May is Multiple Sclerosis (MS) Awareness month, so it seems fitting to discuss some recent research regarding exercise and MS. An estimated 100,000 Canadians are living with MS.6 Up to 78% of people with MS engage in no physical activity.2
In 2013, the Canadian Society for Exercise Physiology (CSEP) and the MS Society of Canada published Physical Activity Guidelines for adults with MS.1 General activity guidelines don’t provide “optimal recommendations for people with a disability,”2 meaning these MS-specific recommendations are especially important.
Health-care providers and people with MS alike are often taught to avoid fatigue out of fear that this will cause the symptoms of MS to worsen. This advice, combined with a historical lack of information about the appropriate dose of exercise for people with MS, undoubtedly contributed to a lack of activity among this group.
The new CSEP Activity Guidelines challenge some of these long-standing notions and offer direction to health and exercise professionals regarding the minimum dose necessary to improve fitness for people with relapse remitting and progressive types of MS.2 The recommendations1 include:
30 minutes of moderate intensity aerobic activity, two times per week
Strength training exercises for major muscle groups, two times per week
The potential benefits of following these guidelines include:
Improved quality of life
More importantly, since the guidelines are the result of an extensive literature review, you can have confidence in their recommendations. The authors noted that “there was consistent and strong evidence that aerobic and resistance exercise performed two times per week at a moderate intensity increases physical capacity and muscular strength, respectively.”3
The authors went on to say that “while the evidence supporting the benefits of exercise on mobility and fatigue is promising, there is insufficient evidence to definitively establish the prescriptive amounts, intensities or types of exercise to improve these outcomes.”3 From a practical point of view, this means that there’s no one right way to be active with MS, so how you choose to be active can be tailored to your preferences. That’s good news since this flexibility has been found to be an effective way of encouraging all adults to start and continue with a physical activity program.4,5
It’s important to get help at the start of a program in order to have some guidelines for how to proceed. In addition, supervised exercise may be more effective than unsupervised exercise in attaining the benefits described, both due to an increased likelihood of continuing to participate and progressing when the program becomes too easy for you.3
The take home message is clear: while people living with MS experience significant benefits from regular physical activity, most are not active enough. A physiotherapist can help you to get started and can give you suggestions for how to progress your program as you become stronger. To find a physiotherapist, click here.
Canadian Society of Exercise Professionals. Canadian physical activity guidelines for adults with Multiple Sclerosis. Accessed online at: http://csep.ca/CMFiles/Guidelines/specialpops/CSEP_MS_PAGuidelines_adults_en.pdf
Latimer-Cheung, A.E.; Ginis, K.A.M; Hicks, A.L.; Motl, R.W.; Pilutti, L.A.; Duggan, M.; Wheeler, G.; Persad, R.; Smith, K.M. (2013). Development of Evidence-Informed Physical Activity Guidelines for Adults with Multiple Sclerosis. Archives of Physical Medicine and Rehabilitation; 2013; 94:1829-36.
Latimer-Cheung, A.E.; Pilutti, L.A.; Hicks, A.L.; Ginis, K.A.M;Fenuta, A.M.; MacKibbon, K.A.; Motl, R.W (2013). Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with Multiple Sclerosis: A systematic review to inform guideline development. Archives of Physical Medicine and Rehabilitation; 2013; 94:1800-28.
Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl HW, Blair SN. Comparison of Lifestyle and Structured Interventions to Increase Physical Activity and Cardiorespiratory Fitness JAMA; 1999; 281(4):327-334.
Marcus BH, Forsyth LAH, Stone EJ, Dubbert PM, McKenzie TL, Dunn AL, Blair SN. Physical Activity Behaviour Change: Issues in Adoption and Maintenance. Health Psychology 2000; 19(1Supplemental): 32-41.
Multiple Sclerosis Society of Canada. About MS. Accessed online at: https://beta.mssociety.ca/about-ms