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Benefits of an Exercise Program

AUTUMN
DIAGNOSED IN 2013

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In this article

Overview

In addition to being essential to general health and well-being, exercise is helpful in managing many MS symptoms. A study published by researchers at the University of Utah in 1996 was the first to demonstrate the benefits of exercise for people with MS. Those patients who participated in an aerobic exercise program benefited from:
  • better cardiovascular fitness
  • improved strength
  • better bladder and bowel function
  • less fatigue and depression
  • a more positive attitude
  • increased participation in social activities
Additional studies have confirmed the benefits of exercise, including improvement in cognitive function and mood enhancement. Inactivity in people with or without MS can result in numerous health problems including many risk factors associated with coronary heart disease, muscle weakness, decreased bone density, and shallow, inefficient breathing.

Exercise and MS

An exercise program must fit the capabilities and limitations of the individual. It may need to be adjusted as changes occur in MS symptoms. Any person with MS who is initiating a new exercise program should also consult with a physician before starting.

Periods of exercise should be carefully timed to avoid the hotter periods of the day and prevent excessive fatigue. Fatigue experienced after an exercise session should not exceed approximately 2 hours.  If fatigue from the workout exceeds 2 hours, then it is recommended that the intensity, frequency, and/or duration of the workout be reduced. With some guidelines, an exercise program can help maintain good health.

Types of physical activity

Yoga, Tai Chi, Aquatics, exercise routines at the gym, cycling, dance, balance training, aerobic exercises and other activities such as gardening, boating and active chores can provide the benefits of physical movement. In order for the person to participate on a regular basis and stay motivated, the activity needs to be enjoyable and geared to his or her abilities and limitations.

Yoga and MS Featuring Eric Small

Role of the fitness professional

As fitness and wellness professionals, you teach activities that focus on movement to positively impact activities of daily living.  Rehabilitation professionals focus on therapeutic services with goals that differ from those of general fitness instruction.  As an instructor, remember to stay within your realm of practice, and when needed, refer on to the appropriate health professional.  Share information and experience, but refrain from giving personal interpretations or advice, or offering specific treatment recommendations.

Do:
  • Use general screening and non-invasive assessments of strength, endurance, range of motion, etc.
  • Design and implement a program that addresses the body as a whole.
  • Encourage the participant to perform the activity independently, providing hands-on assistance only if needed for guiding/cueing and safety.
  • Stay within your realm of practice and expertise. Refer students to others for accurate advice about matters outside your field. 
Don’t
  • Assess neurological manifestations or evaluate symptoms.
  • Make a diagnosis and/or prescribe a treatment-based program for specific symptoms.
  • Unless trained, do not attempt to transfer the participant or allow other students in the class to assist. Do not passively move the student’s limbs.
  • Provide information outside of your area of expertise.

An intergrated approach to fitness

Functional fitness maximizes the efficiency of the body’s physiological system to help manage activities of daily life. By using exercises that focus on building a body capable of doing real-life activities in real-life situations, participants will make the most effective use of their time and effort. The key to a functional approach is integration. It’s about training all muscles to work together for a specific purpose rather than isolating them to work independently.

Five components

When successfully combined into the 5 component of fitness, functional exercise can help maximize strength and minimize overuse of muscles that may already compensate for weaker counterparts and /or changes in MS.

1. Strength & Endurance:  Strength training uses resistance to challenge muscles, which can improve muscle strength, bone density, muscle mass, flexibility and balance to help prevent injury. Weakness is a common problem in MS and has numerous and varied causes. A properly designed and executed physical activity program can help address areas of weakness and imbalance in the body and increase endurance during activity over time.
  • An example of a good functional exercise for an individual who uses a wheelchair for primary mobility is triceps extensions.  This exercise is appropriate because the triceps muscles are necessary to help with pushing oneself up off/out of the wheelchair for transfers and/or repositioning within the wheelchair.
  • An example of a good functional exercise for an ambulatory individual may be squats.  This exercise is appropriate because it translates into functional mobility with getting into/out of a chair or a car, among other daily activities.

2. Flexibility & Range of Motion: For individuals living with MS, lack of movement can sometimes translate to loss of flexibility which limits range of motion. Flexibility exercises can improve joint integrity, prevent injury and release stress.

3. Cardiovascular Exercise: Cardiovascular exercise is activity that involves the larger muscles, increases heart and respiratory rate and keeps the heart rate elevated for a period of time. Cardio is good for the heart and, especially for individuals with MS, can help fight fatigue and increase endurance. Use the Perceived Exertion scale (0-10) to monitor exertion before, during, and after exercise.  Warm up/cool down should be at 1-2/10 RPE (Rated Perceived Exertion); exercise zone at 3-5/10 RPE. Examples of cardio exercise include walking, elliptical, stationary bike, arm cycle and swimming.

4. Relaxation & Body Awareness: The purpose of relaxation is to consciously dampen physical processes through manipulation of cortical influences. Physiologically, as one relaxes, muscle tension decreases (which can help reduce spasticity for someone living with MS), the heart and respiratory rates slow, and mental attention shifts, helping to increase concentration.
  • Through purposeful breath and movement, an individual can relax the body and decrease muscle tension, slow heart and respiratory rates, and shift mental attention in order to increase concentration that aids body awareness.
  • Body awareness is a heightened consciousness of how the body moves. Such awareness can help identify and address any changes, needs or poor movement patterns in the body.
  • Mind/body techniques like those used in yoga and Tai chi and visualization techniques like those used in Feldenkrais, enhance the body’s ability to make adjustments to movement execution, possibly enabling the body to adapt to its sometimes-changing ability levels as affected by MS.
  • Living with MS can mean change and stress, which can deplete an individual both emotionally and physically, potentially increasing fatigue. Physical activity acts as a form of stress management. Yoga, Tai Chi, aquatics, Pilates and Feldenkrais can can assist in lowering levels of harmful stress hormones that may be impacting the immune system.
5. Balance & Coordination:  Coordination and balance involve a sequence of muscle actions to control movement. Balance and coordination problems are quite common among people with MS and can result in poor posture and body alignment. Exercises that promote proper posture are essential to effective body mechanics and extremely important in maintaining proper alignment.







 

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