Multiple sclerosis (MS) is a chronic, disabling disease of the central nervous system that is mainly diagnosed between the ages of 20 and 40 years; its incidence is approximately 6 in 100,000 people.

What is Multiple Sclerosis

Multiple sclerosis or MS is a disease that affects the brain and spinal cord resulting in loss of muscle control, vision, balance, and sensation (such as numbness). It is an autoimmune disease in which the nerves of the brain and spinal cord are damaged by one's own immune system. In MS, the immune system attacks the brain and spinal cord, the two components of the central nervous system.

The central nervous system is made up of nerves that act as the body's messenger system. Each nerve is covered by a fatty substance called myelin, which insulates the nerves and helps in the transmission of nerve impulses, or messages, between the brain and other parts of the body. These messages control muscle movements, such as walking and talking. Multiple sclerosis causes damage to myelin thus disrupting the transmission of nerve messages and affects bodily function.

Functional Implications

In addition to the neurological symptoms, more than 70% of patients with MS experience fatigue, and 50% to 60% report fatigue as one of their worst symptoms. Fatigue can be so persistent that it leads to limitations in social functioning, even in patients with minor neurological deficits. The causes of fatigue in people with MS are largely unknown, but one of the assumed causes is reduced aerobic capacity.

Regular physical activity has long-term positive effects on health and the prevention of additional health problems. In the general population, the benefits and protective effects of a physically active lifestyle are well known, including an increased life expectancy free of disability, lower risk of chronic diseases (eg, coronary artery disease, stroke, diabetes mellitus type II, colon cancer), and unhealthful weight gain. A patient with MS may experience even greater gains from physical activity than those mentioned above.

Exercise and Multiple Sclerosis

There is strong evidence in favor of exercise therapy compared with no exercise therapy, but there is no evidence that specific exercise programs are superior to others in improving activities and social functioning. One of the primary aims of rehabilitation in people with MS is to maintain and improve functional independence. Studies suggest that exercise therapy may be beneficial for patients with MS in terms of physical fitness, activities of daily living, and outcomes related to mood. In particular, aerobic exercise seems to be a promising rehabilitative tool for patients with MS because it could positively affect both maximum exercise capacity and daily physical activities.

Physical therapy and Multiple Sclerosis

Physical activity should be properly prescribed by a licensed medical professional with the goal to improve or maintain function and not exacerbate MS symptoms. An exercise program needs to be appropriate to the capabilities and limitations of the individual, and may need to be adjusted as changes occur in MS symptoms.

A physical therapist experienced and educated in the unique and varied symptoms of MS can be helpful in designing, supervising and revising a well-balanced exercise program. Any person with MS who is initiating a new exercise program should also consult with his or her physician before starting. Periods of exercise should be carefully timed to avoid the hotter periods of the day and prevent excessive fatigue. With some guidelines, a good exercise program can help to develop maximum muscle mass, bone density and respiratory capabilities, thereby avoiding gross fatigue and exacerbation of MS symptoms.