Exercise as it relates to Disease/Exercise prescription for multiple sclerosis patients

What is Multiple Sclerosis?
Multiple Sclerosis (MS) is a autoimmune disorder of the central nervous system. MS is characterised by the deterioration of the myelin that covers cell fibers in the brain and spinal cord with subsequent destruction of oligodendrocytes and axons. The demyelination of nerve fibres causes axon conduction velocity to slow and consequently results in functional impairments such as reduced mobility, muscle weakness, fatigue, poor balance, abnormal gait mechanics and cognitive and autonomic dysfunctions. An estimated 23,700 Australians suffer from MS (0.1% of the population) and of those affected, an estimated 75% are female.

What is the cause of MS?
The cause of MS is still unknown. It is thought that a combination of genetic and environmental factors may contribute to MS, but the distinct trigger has not yet been discovered.

Symptoms
There are many possible symptoms of MS. Symptoms will vary from person to person, depending on the severity of their disorder. The most common notable symptoms are:


 * Vision Problems
 * Dizziness and Vertigo
 * Fatigue & Weakness
 * Numbness & Tingling
 * Walking (Gait), Balance and Coordination problems
 * Bladder, Bowel & Sexual Dysfunction
 * Chronic Pain & Involuntary Spasms
 * Emotional Changes
 * Depression
 * Cognitive Dysfunction

Barriers to Exercise
The acceptance of exercise as a positive treatment for MS patients is continually growing. Despite this there are still a number of individual barriers that prevent MS sufferers from participating in exercise these include;
 * Lack of self belief in successfully participating
 * Fear of increasing fatigue symptoms after exercise
 * Perceived lack of benefits
 * Safety concerns
 * Lack of enjoyment

Exercise Recommendations
Exercise is not a cure for MS. However, it has been found to have beneficial affects on reducing MS symptoms severity and subsequently restoring quality of life to sufferers. Beneficial training types and their individual recommendations are as follows

Exercise Considerations
Exercise considerations for MS patients should be assessed before, during and after exercise;
 * Before commencing an exercise program a doctor or appropriate physician should be consulted for preliminary testing
 * The exercise program should be designed specifically for the patient, dependent on physical limitations and current fitness level (determined by preliminary testing)
 * Appropriate goals should be set and assessed; before, during and after the program
 * Patient fatigue should be recorded; before, during and after exercise (exercise should be avoided if fatigue is reported on that day)
 * The patient should be observed during exercise for signs of fatigue and loss of coordination
 * Heart rate, blood pressure and patients perceived exertion should be monitored during exercise
 * Patients should not exercise on hot days (unless in water)