In the past, people with multiple sclerosis were advised to avoid exertion. It was felt that as many people with MS experienced fatigue and found their symptoms worsened when hot, it was best to avoid activities that could be seen as tiring.
This view has now been overturned and a research study in 1996 showed specific benefits of exercise for people with MS. The trial compared a group of people with mild to moderate MS who followed an exercise programme for 15 weeks with a similar group who didn't exercise. None of the people in either group had been exercising before the trial.
At the end of the trial, people from the exercise group were showing reduced fatigue levels and improvements in strength, mobility and bowel and bladder function. They also reported improved mood and showed a reduction in stored fat and markers associated with the risk of cardiovascular disease.
Similar effects have been seen in a number of subsequent studies into exercise and MS.
Exercise to combat fatigue
Although not properly understood, weakness and fatigue in multiple sclerosis are thought to be caused by the poor transmission of messages by damaged nerves. Muscles that are not used regularly become weakened and require more energy to do tasks. This can lead to a cycle of decline, as an already weak muscle that is not used will become weakened further, a process known as atrophy. Regardless of MS, a lack of activity will lead to increased fatigue.
As muscle weakness in MS is due to problems with getting messages along the nerves rather than within the muscle itself, expending a great deal of energy by exercising to the point of exhaustion doesn't help the problem and can make fatigue and weakness worse. Exercise that works on building up endurance and strength in muscles without increasing fatigue is considered beneficial.
What sort of exercise?
If an activity doesn't make symptoms worse, it is likely to be fine. However, the attitude of 'no pain, no gain' does not apply in MS. Whilst someone without MS can push themselves to exhaustion and then recover within half an hour, it is not a good idea for someone with MS to 'work through' fatigue as this can leave them feeling worse, sometimes for days afterwards. A person with MS should be prepared to stop before their body is telling them they have reached their limit.
- Annals of Neurology 1996;39:432-441. Summary Impact of aerobic training on fitness and quality of life in multiple sclerosis.
Last updated: 12 August 2014
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