Investigating safe and effective exercise for people with MS
Dr Johnny Collett
School of Life Sciences, Oxford Brookes University
Way Ahead 2009;13(1):5
For many years, people with MS have limited their physical activity levels on the advice of physicians in an effort to help minimise the risk of exacerbations and symptoms of fatigue1. However, over the last decade the beneficial effects of exercise for people with MS have become evident.
A variety of exercise programs, including aerobic and anaerobic interventions, have been shown to be effective in improving muscle power, exercise tolerance and mobility-related activities without increasing fatigue levels2-8.
However, information to guide the clinician on optimal dose and whether you can 'work' someone too hard is lacking. In order to investigate safe and effective exercise on people with MS we are undertaking a study examining how people with MS respond to different intensities of exercise.
In phase I of the study we are evaluating the immediate physiological, neurological (central fatigue and autonomic response) and psychophysical (perceptions of excursion, vitality and fatigue) response to a single exercise session. The exercise is performed on a cycle ergometer in order to control work rate. Preliminary results suggest that all intensities are well tolerated.
Phase II of the study is a single blind randomised trial to investigate the effectiveness of different intensities of exercise delivered over a 12-week period. The exercise will again be performed on cycle ergometers. Outcome will be determined by measures of health, quality of life, fatigue, mobility, activity, immune function and neurotrophin levels. Qualitative results from focus groups and interviews will also explore themes of enjoyment, adherence and confidence.
The results of this phase II study will be published in a future issue of Way Ahead. It is hoped that the study will support future development of comprehensive evidence based guidelines that will help the clinician deliver optimal exercise interventions.
References
- Rasova K, Havrdova E, Brandejsky P, et al.
Comparison of the influence of different rehabilitation programmes on clinical, spirometric and spiroergometric parameters in patients with multiple sclerosis.
Mult Scler 2006;12:227-234. - Smith R, Adeney-Steel M, Fulcher GP, et al.
Symptom change with exercise is a temporary phenomenon for people with multiple sclerosis.
Mayo Clinic Proceedings 2006;87:723-28. - Rietberg MB, Brooks D, Uitdehaag BMJ, et al.
Exercise therapy for multiple sclerosis.
Cochrane Database of Systematic Reviews 2005. - White LJ, Dressendorfer RH.
Exercise and multiple sclerosis.
Sports Med 2004;34:1077-1100. - Romberg A, Virtanen A, Aunola S, et al.
Exercise capacity, disability and leisure physical activity of subjects with multiple sclerosis.
Mult Scler 2004;10:212-218. - Solari A, Filippini G, Gasco P, et al.
Physical rehabilitation has a positive effect on disability in multiple sclerosis.
Neurol 1999;52:57-62. - Wiles C, Newcombe RG, Fuller KJ, et al.
Controlled randomised crossover trial of the effects of physyotherapy on mobility in chronic multiple sclerosis.
J Neurol Neurosurg Psychiatry 2001;70:174-179. - Carter P, White CM.
The effect of a general exercise training on effort of walking in patients with MS.
14th International World Confederation for Physical Therapy. 2003. Barcelona.
- Move it for MS
- If you would like to distribute fliers for the MS Trust's 'Move it for MS' DVD, featuring Mr Motivator, contact the MS Trust.
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