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Exercise and Physical Activity Recommendations for ALL People with MS: Guidelines and Videos Available

May 14, 2020

Physical activity and exercise have been shown to be beneficial to people with MS, and are behaviors that contribute to wellness. Studies suggest that people living with MS are less active than those without MS. To provide the MS community with evidence-based guidance for promoting exercise and lifestyle physical activity, the National MS Society convened a group of experts in the fields of MS, exercise, rehabilitation, and physical activity to review available studies and develop recommendations for healthcare providers who can advise individuals with MS at all disability levels. Please scroll down for specific recommendations and helpful videos.
 
Importantly, the group looked at both lifestyle physical activity (leisure, occupational, or household activities that are moderate to vigorous) and exercise (structured leisure-time physical activity that is usually performed repeatedly over a period of time) to develop their recommendations. These recommendations have now been published, and have been endorsed by the Consortium of Multiple Sclerosis Centers:
  • Healthcare providers are encouraged to promote exercise and lifestyle physical activity to every person with MS, emphasizing its safety and the benefits.
  • People diagnosed with MS should be evaluated as early as possible by a rehabilitation specialist  or exercise or sport scientist who is experienced in MS, to establish an individualized exercise and/or lifestyle physical activity plan.
  • Healthcare providers should encourage people with MS to complete 150 minutes per week or more of exercise, and/or 150 minutes per week or more of lifestyle physical activity. Individuals are encouraged to make gradual progress toward this goal, based on their abilities, preferences, and safety. (See table below for specific recommendations.)
  • Since other health conditions and symptoms can be barriers, it’s important to set exercise goals in communication with the individual’s healthcare provider. If disability increases and exercise/physical activity becomes more challenging, referrals to exercise specialists trained in MS are essential to ensure safety.
  • When physical mobility is very limited, individuals should exercise with the help of a trained assistant.
 
NEW EXERCISE VIDEOS: Along with these guidelines, the Society has produced videos to guide people with MS at all disability levels through stretching, aerobic, and breathing exercises.
 
Table: The following table provides a brief summary of exercise recommendations. Consideration should be given to the need for rest breaks, individual heat sensitivity, caregiver assistance, safety and adaptations to reduce the risk of falls, and consultation with a rehabilitation specialist.

 
Condition/abilities Exercise Recommendation Example Physical activity example
People with mild impairment ( (may include symptoms of fatigue, imbalance, walking, strength, and memory) Aerobic exercise→
Advanced aerobics→
Resistance exercise→
Flexibility exercise→
Neuromotor exercise→
Stationary bike, walking
Running, road cycling
Free weights, resistance band
Yoga, stretching
Tai chi, virtual reality
Active gaming
People with MS whose walking is limited (people who fall, require mobility aids or assistance with transfers) Breathing
Flexibility→
Upper extremities→
Lower extremities→
Core→
Spirometer
Stretch upper/lower joints
Arm cycling, weights
Standing, walking w/ walker
Abdominal muscle exercises
Active weight shifting
Seated dancing, yoga, boxing
People using wheelchairs Breathing
Flexibility→
Upper extremities→
Lower extremities→
Core→
Spirometer
Stretch upper/lower joints
Arm cycling, weights
Standing frame
Abdominal muscle exercises
Active participation in activities of daily living as able,
Pressure relief (press-ups)
 
People confined to bed or chair Breathing
Flexibility→
FES→
Spirometer
Range of motion for joints
Electrical stimulation/muscle
Bed mobility with assistance,
Activities of daily living (e.g., dental hygiene) with assistance
 
 
The COVID-19 pandemic makes some exercise goals difficult to achieve. The Centers for Disease Control provide some advice for overcoming barriers to increasing physical activity.
 
“Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course” by Drs. Rosalind Kalb, Robert Motl, and collaborators is published in the MS Journal.
 

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system. Symptoms range from numbness and tingling to blindness and paralysis, and there is currently no cure for MS. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. An estimated 1 million people live with MS in the United States. Most people with MS are diagnosed between the ages of 20 and 50, and it affects women three times more than men.

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