As recently as twenty years ago, people with multiple sclerosis (MS) were advised to avoid physical activity/exercise because it could increase symptoms or possibly even increase disease activity. Today it is well accepted that exercise is beneficial in maintaining or increasing one’s health, decreasing secondary complications and improving psychological well-being. Some of the newest areas of research are around the anti-inflammatory and potential neuroprotective factors of exercise.
The Surgeon General’s 1996 Report on Physical Activity and Health outlined the importance of exercise. The report stressed that physical activity need not be strenuous to achieve health benefits and significant health benefits can be gained with moderate amounts of physical activity. These are important factors for people with MS because of the problems with fatigue. The benefits of physical activity include reducing the risk for coronary heart disease, high blood pressure, colon cancer and diabetes. In addition, it can help improve stamina and muscle strength. These findings emphasize the importance of physical activity in improving health and reducing the risk for premature death.
Research specific to MS is also convincing in showing that people with MS can gain many of the same benefits of exercise as those without a diagnosis of MS. An article published by Petajan, et.al in 1996 demonstrated the positive effects of a 15 week aerobic exercise program for people with multiple sclerosis. Individuals performed an exercise program 3 times per week. The positive effects included improved endurance, flexibility, strength and an overall sense of well-being. This study also showed improvements in bowel and bladder function.
Another study published by Oken and colleagues in 2004, showed improvements in secondary measures of fatigue. Improvements were seen with individuals performing either a weekly aerobic exercise or a weekly yoga class.
Schulz and colleagues (2004) showed the impact of exercise on areas such as quality of life, coordination as well as immune-endocrine parameters and neurotrophic factors. Patients in this study performed exercise two times per week for 8 weeks and demonstrated improvements in a quality of life measure with particular significance in social functioning and mood. In addition, statistical significance was seen in lower extremity coordination for the exercise group. The authors felt that the difference may have been due to deterioration in coordination for the control group and not a reflection of improved coordination in the training group. Finally, the training group did show increases in nerve growth factors, but these were not statistically significant when compared to the control group. However, in 2003 this same group of researchers did show that nerve growth factors could be induced with moderate exercise. It was a short term study so the long term effects are not known. Also, in 2002 researchers at the University of Buffalo demonstrated anti-inflammatory effects of exercise.
These preliminary results demonstrate that exercise may have some neuroprotective or perhaps even restorative benefits.
Exercise can be a positive therapeutic ritual. The use of exercise as a therapeutic ritual provides people with chronic disease an activity around which they can organize their day and focus on a healthy activity. A secondary benefit may be a positive effect on the disease process.