Multiple Sclerosis - A Practical Guide to Rehabilitation - 44

AIMS

A PRACTICAL GUIDE TO IDIOPATHIC PULMONARY FIBROSIS

Health and Wellness in MS
MS is a chronic condition that can impact many
dimensions of quality of life. Clinicians must be
mindful of the inter-relatedness of MS symptoms
that sometimes culminate in a vicious circle. For
example, fatigue may limit a person's willingness
or motivation to exercise; reduced exercise may
lead to spasticity or constipation; spasticity may
interfere with sleep quality; and sleeplessness may
amplify fatigue. The rehabilitation team can
support positive, healthy choices to promote an
overall balance of physical, social, spiritual, and
emotional well-being for individuals with MS
throughout the course of this chronic disease.

EXERCISE
In a recent review, Motl et al noted that "exercise
training represents a behavioral approach for
safely managing many of the functional,

symptomatic, and quality of life consequences of
multiple sclerosis."174 Indeed, exercise training in
patients with MS has been shown to provide
improvements in walking, balance, fatigue,
cognitive function, depression, and quality of
life.175,176,177 Exercise can improve muscular and
aerobic fitness in patients with MS, and may also
benefit sleep quality and reduce cardiovascular
and metabolic comorbidities.174 Moreover, exercise
has been associated with reductions in MS relapse
rates and slowing of disability progression.178,179
Available evidence has been used to develop
guidance for aerobic and strength training in
patients with MS who have mild-to-moderate
disability (Table 15)180 Note, however, that the
guidance below is not intended for individuals
with more severe disease. Further, regardless of

Table 15. Guidance for Exercise in Patients with MS and Mild to Moderate DisabilityAdapted from 180
Aerobic Activity
Frequency

2x weekly

Types
2x weekly

* Aerobic and strength training activities can be done on the same day
* Muscles should be rested for > 1 day between strength training sessions
Quantity

* Gradually increase activity to > 30
minutes during each workout session

* Try to do 10-15 repetitions of each
exercise
* Gradually work up to doing 2 sets of
10-15 repetitions of each exercise

Intensity

* Perform exercises at moderate
intensity
- Usually defined as 5-6 on a scale of
10 and causes heart rate to increase
- As a general rule, can talk but not
sing a song during the activity

* Pick a resistance (eg, free weights,
cable pulleys, bands) heavy enough to
barely, but safely allow completing
10-15 repetitions of the last set
* Rest for 1-2 minutes between each set
and exercise

Examples

* Upper body exercises: arm cycling
* Lower body exercises: walking, leg cycling
* Combined upper and lower body
exercises: elliptical trainer

Upper and lower body
* Weight machines
* Free weights
* Cable pulleys

Other types of exercise with potential benefits
* Elastic resistance bands
* Calisthenics
* Aquatic exercise
* Yoga or Tai Chi

44

Health and Wellness in MS



Multiple Sclerosis - A Practical Guide to Rehabilitation

Table of Contents for the Digital Edition of Multiple Sclerosis - A Practical Guide to Rehabilitation

Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Contents
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 1
Multiple Sclerosis - A Practical Guide to Rehabilitation - 2
Multiple Sclerosis - A Practical Guide to Rehabilitation - 3
Multiple Sclerosis - A Practical Guide to Rehabilitation - 4
Multiple Sclerosis - A Practical Guide to Rehabilitation - 5
Multiple Sclerosis - A Practical Guide to Rehabilitation - 6
Multiple Sclerosis - A Practical Guide to Rehabilitation - 7
Multiple Sclerosis - A Practical Guide to Rehabilitation - 8
Multiple Sclerosis - A Practical Guide to Rehabilitation - 9
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Multiple Sclerosis - A Practical Guide to Rehabilitation - 14
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Multiple Sclerosis - A Practical Guide to Rehabilitation - 22
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Multiple Sclerosis - A Practical Guide to Rehabilitation - 65
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover3
Multiple Sclerosis - A Practical Guide to Rehabilitation - Cover4
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