March is National Multiple Sclerosis month. Multiple sclerosis (MS) is a disease in which the immune system has an abnormal response in the body and affects the central nervous system (CNS). This immune response in the CNS creates inflammation that damages the myelin covering of nerves within the brain, spinal cord, and optic nerves. Myelin is a fatty substance that surrounds and insulates nerve fibers. This allows for electrical impulses to travel quickly and efficiently along the nerve cells.
What Causes MS and What Happens to Your Body…
When the myelin or nerve fibers are damaged or destroyed, the messages within the CNS are altered or even stopped completely. Damage to different areas in the CNS can produce a variety of neurological symptoms. These symptoms vary from person to person and can include muscle spasms, increased fatigue, difficulty walking, difficulty balancing, pins and needles, and muscle rigidity. Once areas are damaged, scar tissue develops which gives the disease name multiple sclerosis (multiple scarring).
The cause of MS is unknown. MS is thought to be influenced by multiple factors including genetic susceptibility, environmental factors, and abnormalities in the immune system. There are four types of identifiable MS disease courses, clinically isolated syndrome, relapsing-remitting, secondary progressive, and primary progressive.
Solutions
There is currently no known cure for MS. However, there are over a dozen treatments to help modify the MS disease process including medications and different therapy types. One way to help maintain independence and help with the disease progression is through the use of physical therapy. Exercise is an important tool for managing MS symptoms. You should consult with your physician or physical therapist prior to beginning a new program. Regular managed exercise can help increase fitness levels, endurance, and strength in your arms and legs.
Recommended Exercise Options
Aerobic Exercise: Aerobic exercise is an activity that increases your heart rate. This includes walking, riding a stationary bike, rowing, and swimming. Perform exercise at a moderate level. This means you can have a conversation but not sing. A good goal for each week is about 150 minutes of activity. However, it is important to not overdo it with aerobic activity and not push to the point where you can not speak while exercising.
Stretching: Stretching helps improve and maintain mobility and helps to reduce spasticity symptoms associated with MS. Stretching should target both upper and lower extremity muscle groups to improve total body mobility.
Strengthening: Strengthening or resistance training is another way to improve endurance. Using weights or resistance bands can help build muscle strength. You should target both upper and lower extremity muscle groups 2-3 days per week.
Physical Therapy: Physical therapy is one piece of the treatment team puzzle when tackling MS. One of the main goals of physical therapy is to help improve walking, balance, strength, posture, endurance, and reduce pain. Sessions may include gait (walking) training which may involve the use of a brace or cane to improve both safety and endurance without assistance. Physical therapy is a useful tool in helping to improve overall safety at home and allow you to maintain as much independence as possible.
Precautions to take
Before starting to exercise there are a few things that are important to remember with MS. Hydration and staying cool are essential. Heat can be a big detriment to those with MS and can temporarily exacerbate MS symptoms including fatigue and spasticity. For these reasons, it is important to start off slow with activity and make sure to have plenty of water on hand. If the room or area is warm add a fan or turn on air conditioning. If you are outside, try to stay in the shade where it is cooler. It is equally as important to cool down from activity which may include stretching to help ease your heart rate back down. Once finished with exercising, monitoring symptoms is important to make sure you are not overdoing it. If your MS symptoms are exacerbated for 2 hours or more after an activity, reduce your level of exercise.
Takeaways…
- Whether beginning a formal or self-guided exercise program, talk to your neurologist or primary care physician to review any safety concerns.
- If you arent ready to get right into a higher intensity program or had a recent exacerbation, physical therapy is a good starting point to improve mobility, strength, balance, and safety.
- Take the first step by contacting your local physical therapist. Learn more about how the two of you can work together to help improve your home safety & improve the ability to maintain as much independence as possible.
Resources: https://www.nationalmssociety.org/Treating-MS/Rehabilitation#section-1
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