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.