Exercise as it relates to Disease/Aerobic or Resistance training for Multiple Sclerosis?

What is Multiple Sclerosis?
Multiple Sclerosis is the demyelinating inflammatory disease of the CNS with subsequent destruction of myelin, oligodendrocytes and axons. The disease process involves the activation and transport of inflammation cells to brain. The exact cause and sequence that leads to this process are yet to be determined; however we do know increased activation of natural killer cells to attack myelin proteolipid protein characterizes the pathogenesis of MS. Myelin plays the role of speeding up nerve impulses. Demyelination compromises nerve fiber function by slowing axonal conduction velocity [2]. MS can cause axial injury or death. Altered conduction in motor and sensory tracts within the CNS can disturb gait and balance, increase the risk of falls and reduce daily lifestyle activity [2]. MS symptoms include balance issues, lack of proprioception, visual problems, muscle weakness and fatigue, elimination dysfunction, depression and anxiety, and a higher risk of respiratory diseases, heart disease, and metabolic disorders[1]. Multiple Sclerosis affects 23,000 Australians, 73% of which are women. The mean age of diagnosis is 30years.

What causes MS?
Although we understand the chemical process of MS the cause which starts the process has not yet been discovered.

Treatment of MS
MS is an incurable disease however there are different avenues that can be taken to try to prevent or slow its progression. Not only does the actual disease need to be treated, but also the symptoms that can debilitate sufferers. MS is a disease that can affect sufferers constantly or in relapses[3].

Depending on the type of symptoms and their severity there are different types of drugs which doctors prescribe. Researchers are exploring the positive implications of physical exercise to improve functional capacity and quality of life in MS patients, this can include aerobic and resistance training but also other types of exercise including yoga and aqua aerobics.

Considerations and Barriers for Exercise
When undertaking exercise there are many things to consider: * Before beginning an exercise program graded exercise testing can provide information about an individuals limitations, aerobic fitness, strength, and functional capacity[12] * Time of day - Training in excessive heat and humidity can affect a patients work capacity, patients will tolerate exercise better earlier in the day in cooler temperatures[12] * Stretching before and for 10-15mins post exercise will aid in managing fatigue and avoiding muscle tightness[1] * Patients with exacerbated symptoms should only exercise under permission from a health professional[9]

MS is a dibilitating disease and many patients report barriers stopping them from being able to exercise, these include: * Fatigue[10] * Lack of support * Lack of motivation or psychological stress[7] * Exacerbation of symptoms[12] * Sickness or injury[10]