Attitudes about exercise and MS have changed dramatically. In the past, regular exercise was not generally recommended for people with MS. However, more recent research indicates that exercise produces multiple beneficial effects and may actually be one of the best nonpharmacologic strategies for alleviating multiple MS symptoms. Appropriate forms of regular exercise are now routinely recommended for people with MS.

The Benefits of Exercise for People with MS

In the area of MS and exercise, a landmark study was published in 1996. This study significantly changed the attitudes and approaches of health professionals toward exercise in MS. This study of 54 people with MS evaluated the effects of 40 minutes of aerobic exercise that was done three times weekly for 15 weeks.

The range of MS-associated symptoms that may potentially improve with exercise is remarkable. To summarize, exercise may improve:

  • Strength, walking, and spasticity
  • Anxiety, depression, and anger
  • Bowel, bladder, and sexual function
  • Cognitive function
  • Sleep
  • Fatigue
  • Pain

General Health Benefits of Exercise
In addition to its effects on MS symptoms, exercise has other significant general health benefits. The list of exercise effects in this area is long and wide-ranging:

  • Reduces the risk of heart disease and stroke
  • Lowers blood pressure and improves blood lipids (cholesterol)
  • Helps with weight management and decreases the risk of obesity and obesity-related diseases
  • Decreases the risk of diabetes and helps with diabetes control
  • Decreases the risk of some forms of cancer, including colon, breast, prostate, and uterine lining (endometrium)
  • Prevents and treats osteoporosis, which may occur in MS
  • Reduces overall risk of death

As can be seen, many of the general health effects of exercise are on typical lifestyle diseases that are not directly related to the nervous system, such as heart disease, high blood pressure, diabetes, and obesity. However, studies indicate that having one of these lifestyle diseases along with MS is associated with higher level of neurological disability and lower overall quality of life.

Exercise Programs and Recommendations

Many exercise programs are possible for people with MS. Conventional exercise programs typically include aerobic exercise and strengthening. A well-balanced program also includes stretching and balance exercises, two areas which may be particularly beneficial for those with MS and are often absent from standard exercise programs. Many exercise regimens may be modified so they are appropriate for all levels of physical functioning.

In order to obtain the full benefits of physical activity, it is important for one to have a sense of the physicality of one’s body. Many people who are diagnosed with MS may not already have this sense. In this situation, there may be a type of physical education that is needed, and this may take months or even years to develop. This education may be obtained through physical and occupational therapy, mindful exercising on one’s own, or unconventional exercise programs that focus on slow, mindful movements, including tai chi and yoga and less well-known approaches such as Feldenkrais and Tragerwork.

The absolute best exercise program for people with MS has not been established. A Canadian committee of experts methodically reviewed the large number of clinical studies of exercise and MS and developed guidelines based on these studies (1). The guidelines, which are for people with mild to moderate disability, state that “important fitness benefits” can be obtained with the following regimen:

  • Aerobic activity: at least 30 minutes of moderate intensity activity twice weekly
  • Muscle Strengthening: at least twice weekly strengthening of all major muscle groups

Of note, these exercise recommendations are based only on MS studies.

Exercise programs must be tailored to the interests and needs of the individual. Each person with MS has individualized exercise preferences and, due to the diverse effects of MS, specific physical strengths and weaknesses. These must be taken into account in order to develop a program that is safe and effective.