Exercise as it relates to Disease/Barriers to Exercise in Multiple Sclerosis

Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system. Recurring episodes of MS can cause scarring in the central nervous system as a result of the breakdown of myelin, the insulating material that covers the nerve fibres. This can result in impairment of motor, sensory and cognitive functions.

The cause of MS is unknown and there is no known cure. The primary treatment for MS is pharmacological to help control exacerbation of the symptoms associated with the disease.

Symptoms
The symptoms of MS are associated with the scarring of the central nervous system. The physical symptoms of MS usually present as a combination of:
 * Visual impairment
 * Loss of coordination and balance
 * Muscle spasms
 * Fatigue
 * Speech impediment

Barriers to Exercise
Despite health promoting benefits, many MS patients are often hesitant to participate in physical activity for fear of increasing symptoms or worsening the condition

MS patients report several reasons for avoiding physical activity including:
 * Fatigue accentuating symptoms following exercise
 * Perceived inability to exercise
 * Perceived lack of physical activity benefits
 * Increased scarring exacerbation

There are only a few symptoms which are shown to present a barrier to physical activity in MS patients, such as:
 * Loss of coordination and balance during exercise resulting in injury
 * Physical impairment

Benefits of Exercise
Physical activity has demonstrated many benefits to physical and mental health for sufferers of MS and shown that correct implementation of exercise programmes to be safe for MS patients. Exercise has been shown to have physical health benefits such as:
 * Reduce MS symptoms severity and prevalence
 * Slow degeneration of MS
 * Improve muscular strength
 * Improve balance and coordination
 * Reduce feelings of fatigue
 * Reduce other disease morbidities

Exercise has also been shown to have benefits to the mental health of MS patients such as:
 * Improve wellbeing
 * Reduce depression
 * Improve self-esteem
 * Improve social interactions and support networks

Recommendations & Precautions
Exercise is beneficial to assist in reduction of symptoms for MS sufferers. Some types of training for MS patients include:
 * Aerobic exercise
 * Resistance exercise
 * Respiratory training

MS Specific Considerations for Exercise
 * Pre-cooling
 * Aquatic exercise

Prior to undertaking an exercise regime, individuals with MS should consult with a:
 * Doctor
 * Pharmacologist &
 * Exercise physiologist

External Resources
Multiple Sclerosis Australia http://www.msaustralia.org.au/

Multiple Sclerosis USA http://www.nationalmssociety.org

Multiple Sclerosis Europe http://www.emsp.org/

Multiple Sclerosis UK http://www.mssociety.org.uk/

Multiple Sclerosis Forum for Doctors and Patients http://www.medhelp.org/forums/Multiple-Sclerosis/show/41