Not many years ago, people with multiple sclerosis were advised to stay in bed and not exert themselves. But over the last 20 years, research has shown that exercise benefits those with MS.

Patients energy and balance can increase, muscle atrophy can decrease, according to Multiple Sclerosis News Today. Spasticity (stiffness and involuntary muscle spasms) can be better controlled, and day-to-day life may be easier to manage.

The  importance of exercise for people with MS was stressed by Susan E. Bennett, a clinical professor at the departments of Rehabilitation Science and Neurology at the University of Buffalo and an associate in the UB Neurosurgery department at CMSC 2016, according to Multiple Sclerosis News Today.

Though the progression of the disease is not slowed by regular exercise, cognitive ability and depression can decrease, and an overall sense of well-being can increase.

"Now what’s been shown is 20 minutes of moderate exercise with someone with MS actually promotes the secretion of brain-derived growth factor,” said Bennett.

She suggested that exercise time should be short at first, slowly building up to 20 minutes in a day. The type of MS medication someone takes or the type of MS they have does not seem to affect the benefit exercise offers to MS patients.

Bennett gives the same advice to those with primary progressive MS (PPMS) as she does to those with relapsing-remitting MS (RRMS).

About 15 percent of those with MS have PPMS, where symptoms continue to worsen, without remission. RRMS is the most common form of MS. Relapses, also called exacerbations, will be followed by remissions which are partial or total recovery for a temporary period.

A University of Utah study from 1996 was the first research to indicate that people with MS who exercise aerobically can experience improvement in strength and cardiovascular condition, and better elimination.  They may be less tired or depressed. They may be more inclined to be sociable. Cognition and mood may be elevated.

They may have less risk for coronary heart disease, or bone fracture. Their muscles and bone density may improve.

The benefits of exercise are right there in black and white, but for the person with MS it's not just a matter of will power. MS is a disease that can affect all areas of life and any exercise program must be made to fit the abilities and inabilities of the individual.

Though the person with MS might want to dive into a strong exercise program, they must protect themselves from overexertion.

In general, exercise should not be done during the warmest time of day. It need not be cardiovascular if this poses a problem for the person with MS.

Yoga and tai chi are gentle exercises that may be suitable for someone with MS. Swimming can also be beneficial. And remember that pastimes like cooking, gardening and working around the house count as activity.

A physical therapist can help to design or supervise a program. Any new exercise should also be reviewed by a physician.

It's important to take note that what is recommended for those with MS is moderate exercise, and the MS version is more moderate than for the average American.

For instance Christopher Travers, MS, an exercise physiologist on staff for both Cleveland Clinic Sports Health and Cleveland Clinic Executive Health, describes the general consensus among groups like the American Heart Association and the CDC as being 150 minutes per week or half an hour five days a week.

Heart rate according to this standard should increase by 50 to 60 percent, and talking should be a little more difficult than normal, but without gasping.

The person living with MS needs to keep in mind that moderate for them is just not the same as it is for the rest of the world.

Even well-intentioned friends and family can cause problems if they encourage the person with MS to shoot for "moderate" activity that is 30 minutes at a time rather than 20 minutes. They can cause problems if they are encouraging activity that is too strenuous for the person with MS.

It's essential that those who are ill be aware of what their personal limits are, whether they like them or not. While there is no research to indicate that overexertion can cause a relapse, it can cause muscle pain and strain which those with MS can well do without.

Pushing can cause problems and delay any exercise program. Start small, take it slow, with the hope that exercise can be expanded upon over time.

Reviewed August 2, 2016
by Michele Blacksberg RN
Edited by Jody Smith