The Benefits of Exercise With MS

Adapting takes time.

The MS Challenge Walk in Cape Cod is 2 weeks away now and I have had to increase the amount of time I dedicate each week to exercise so that I will be able to complete the 50 miles in 3 days that the MS Challenge has mapped out!

 

 

This means that I had to adapt my usual routine and work schedule to accommodate more time for walking. I am fortunate to have an understanding boss (myself!) but I confess it has taken some time for me to learn that when you add a significant time commitment to the schedule—something else has to go—even if only temporarily. Overbooking the calendar isn’t good for anyone and this is especially true for those of us with MS and I can now say with certainty that it does not work for me! I am learning to adapt. Preparing properly for the MS Challenge Walk is very important to me personally and I hope participating in the event will be very good for spreading awareness about MS. So, a few days late, I hope you find this information about the benefits of exercise with MS to be useful.

 

Exercise: How Much Is Needed To Be Beneficial?

The Physical Activity Guidelines for Americans, which are evidence based guidelines to help Americans improve their health through regular physical activity. Some of the main points include:

• All adults should avoid inactivity.
• Most benefits kick in with 150 minutes per week of aerobic physical activity.
• If you double your aerobic physical activity to 300 minutes per week you will get additional and more extensive benefit.
• If you have a chronic health condition you should be under the care of a doctor. Talk to your doctor about how your condition impacts your ability to exercise safely (type and amount of exercise). When people with chronic health conditions exercise according to their abilities, exercise is safe.
• People with disabilities benefit from aerobic and muscle strengthening exercises.
• When people are unable to meet the exercise guidelines they should engage in exercise according to their ability and avoid inactivity.
• Takeaway message? Exercise is beneficial for everybody!

 

Research Supports Benefits of Exercise For People With MS

Until relatively recently, people with MS were told to avoid excessive physical activity and exercise because of concerns about worsening disease activity. Instead of being beneficial, this advice seems to have lead to deconditioning, obesity,  metabolic syndrome, and other comorbid chronic health conditions. (Metabolic Syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes). Each of these comorbid health conditions contribute to the overall set of everyday symptoms and medications (with their side effects) that can impact energy levels, sleep quality, bowel and bladder issues and more. Individuals with MS who have chronic comorbid health conditions often experience decreased quality of life and an increase in disability.

 

Don’t find time for exercise; make time for exercise!

 

People with MS are less physically active than people who do not have MS.  A survey of persons with MS identified fatigue, impairment and lack of time as the top three barriers to exercise. Recent studies indicate that, not only can those with MS tolerate physical exercise, it is actually helpful in managing symptoms, preventing complications and comorbid health conditions, and may possibly have neuroprotective benefits.

 

 

Some of the benefits of exercise for people with MS:

• Exercise helps to manage your weight: Being overweight or obese puts you at greater risk for a number of chronic health conditions including coronary heart disease, high blood pressure, type 2 diabetes, stroke, abnormal blood fats, metabolic syndrome, cancer, sleep apnea, gallstones and osteoarthritis. Individuals with MS who have comorbidities often experience decreased quality of life and an increase in disability.

• Exercise improves your ability to do daily activities and prevent falls: Physically active adults have a lower risk of functional limitations (Loss of the ability to do everyday activities such as climbing stairs, grocery shopping, or playing with your grandchildren) than people who are inactive.

• Exercise helps to improve muscle strength, joint and bone health and balance: People with MS are at increased risk of bone fractures. A combination of aerobic, muscle-strengthening and bone-strengthening physical activity can slow the loss of bone density that comes with age. Read more about the role of nutrition in bone health with MS here.

• Research shows that doing balance and muscle-strengthening activities each week along with moderate-intensity aerobic activity, like brisk walking, can help reduce your risk of falling and getting a fracture. Some studies have reported positive effects on reducing muscle spasticity and stiffness in people with MS as well.

• Regular physical activity helps with arthritis and other conditions affecting the joints. Low-impact aerobic activity can improve your ability to manage pain and do everyday tasks, and make your quality of life better.
  

• Exercise improves mood and helps with depression: Depression impacts a lot of people with MS and it can have a significant effect on other symptoms like fatigue, cognition and overall quality of life. Regular physical activity can help keep your thinking, learning, and your judgment skills sharp. It can also reduce your risk of depression and may help you sleep better. Research has shown that doing aerobic or a mix of aerobic and muscle-strengthening activities 3 to 5 times a week for 30 to 60 minutes can give you these mental health benefits.
  

• Exercise can alleviate fatigue: Several studies suggest that regular exercise actually helps to alleviate fatigue. Read about how food can help with fatigue here.
  

• Exercise improves cognition: Aerobic activity and improved physical fitness and is associated with improved cognition in people with MS.
  

• Exercise contributes to bowel regularity: One of the key risk factors for constipation is inactivity. Aerobic exercise can help keep you regular by stimulating more efficient intestinal contractions, which will help to keep things moving.   It also helps to speed up the amount of time it takes for food to move through your digestive system, thus decreasing the amount of water absorbed from the stool into the body.
  

• Exercise may offer neuroprotective benefits: By reducing inflammatory cytokines related to the disease process as well as reducing adipose tissue, which is known to produce inflammatory cytokines, exercise may offer neuroprotective benefits.

• Exercise helps to reduce your risk of chronic health conditions and common MS comorbidities: Heart disease and stroke are two of the leading causes of death in the United States and both are common comorbidities for people with MS. Regular physical activity can lower your blood pressure, reduce your risk for type 2 diabetes, metabolic syndrome and some cancers. I will say it again: Individuals with MS who have comorbidities often experience decreased quality of life and an increase in disability. Read more about the role of nutrition with MS and common chronic health comorbidities here.

 

Tips For Keeping Exercise Safe And Enjoyable

Moderate-intensity aerobic activity, like brisk walking, is generally safe for most people. But you should consult your MD prior to starting a new exercise regimen.

• Start slowly. It’s important to start slowly and gradually increase your level of activity especially if you haven’t been very active and are starting a new exercise plan. Don’t overdo it.
• Warm up! Always warm up before you start a workout and cool down at the end. If you plan to work out for 30 minutes, start with 10-minute workout sessions and work your way up.
• Safety First. Exercise in a safe place. Avoid slippery floors, poor lighting, throw rugs, and other tripping hazards.
• Balance Matters! If you have trouble with your balance, exercise within reach of a grab-bar or rail.
• Listen to Your Body. Stop working out any time you feel sick or you begin to hurt.

 

Are you sensitive to heat?

• Avoid exercising during the hot part of the day (10 a.m. to 2 p.m.).
• Stay well hydrated.
• Pace yourself and pay attention to your body. If you notice any symptoms that you didn’t have before you started exercising, slow down or stop until you cool down.
• Consider exercising in the pool. Just make sure that there are non-slip floors in the locker room and around the pool.
• Do What You Love! Choose an activity you enjoy, and have fun with it!

 

 

Talk with Your Doctor

If you have a chronic health condition like MS, arthritis, heart disease or diabetes talk with your doctor to find out if your condition limits, in any way, your ability to be active. Then, work with your doctor or a physical therapist to come up with a personal exercise program that meets your needs. Physical therapists may make recommendations about:

• The types of exercise that are best for you and those you should avoid.
• How long and intense your workouts should be.
• The right exercises depend on your symptoms, fitness level, and overall health. 
• Any physical limitations for your routines

 

Resources

Here are a few resources to get you started, to help see additional benefits of exercise with MS:

Go here to read more about how a physical therapist can help you.

Go here to find an MS Exercise Challenge offered by Healthline.com

You will get 30 different strength training and mobility exercises designed by a physical therapist for MS patients sent to your email.  I have no affiliation to this program but have tried it myself. Check with your MD before beginning the program.

Go here for the Active MS’ers tips for Exercising with MS: A very thorough and helpful list of exercise tips for Active MS’ers.

 

 

 

Fuel your workout!

In the past I have used an automobile analogy to talk about food as fuel. Remember that with MS, the efficiency of our “engine” is less than optimal but this is made worse by using poor quality fuel: a diet deficient in important nutrients. By putting a higher quality fuel in the tank we are more likely to get the most energy out of our less than efficient engine. Eating a nutrient dense diet will help to set you up for success as you begin your exercise regimen.

 

 

Check out my interview with Jill Walsh who talks about the role that “adapting” played in helping her win a gold medal for Team USA in the para-cycling road world championships in Switzerland last month.

References:

• Beier M, Bombardier C, Hartoonian N, Motl R, Kraft G Improved physical fitness correlates with improved cognition in multiple sclerosis. Arch Phys Med Rehabil. 2014 Jul;95(7):1328-34. doi: 10.1016/j.apmr.2014.02.017. Epub 2014 Mar 4.
• Division of Nutrition, Physical Activity and Obesity | CDC The Benefits of Physical Activity http://www.cdc.gov/physicalactivity/basics/pa-health/
• Glesser BS, Exercise in the management of persons with multiple sclerosis. Ther Adv Neurol Disord. 2015 May;8(3):123-30.
•  Hogan N, Kehoe M, Larkin A, Coote S The Effect of Community Exercise Interventions for People with MS Who Use Bilateral Support for Gait. Multiple Sclerosis International Volume 2014
• Latimer-Cheung AE, et al. Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. Arch Phys Med Rehabil. 2013 Sep;94(9):1800-1828.e3.
• Marck CH, Hadgkiss EJ, Weiland TJ , van der Meer DM, Pereira NG, Jelinek GA Physical activity and associated levels of disability and quality of life in people with multiple sclerosis: a large international survey. BMC Neurology 2014, 14:143
• Motl RW, Sandroff BM. Benefits of Exercise Training in Multiple Sclerosis. Curr Neurol Neurosci Rep. 2015 Sep;15(9):585.
• NIH. National Heart, Lung and Blood Institute. What Are the Health Risks of Overweight and Obesity? http://www.nhlbi.nih.gov/health/health-topics/topics/obe/risks
• Payne C, Wiffen P, Martin S Interventions for fatigue and weight loss in adults with advanced progressive illness. Cochrane Database Syst Rev. 2012 Jan 18;1:CD008427. doi: 10.1002/14651858.CD008427.pub2.
• Rietberg MB, Brooks D, Uitdehaag BM, Kwakkel G. Exercise therapy for multiple Sclerosis: a review. 2011. The Cochrane Collaboration. Chichester, United Kingdom: John Wiley & Sons Ltd. 2011;(1).
• Sandroff BM, Hillman CH, Benedict RH, Motl RW. Acute effects of walking, cycling, and yoga exercise on cognition in persons with relapsing-remitting multiple sclerosis without impaired cognitive processing speed. J Clin Exp Neuropsychol. 2015;37(2):209-19.
• USDHHS. 2008 Physical Activity Guidelines for Americans. http://health.gov/paguidelines/pdf/paguide.pdf