Multiple sclerosis (MS) can result in significant mental and physical symptoms, specially muscle weakness, abnormal walking mechanics, balance problems, spasticity, fatigue, cognitive impairment and depression. Patients with MS frequently reduce their physical activity due to the fear of worsening of the symptoms and this can result in reconditioning.
Historically, individuals living with multiple sclerosis were advised to avoid physical exertion due to the fear that physical activity will make them feel worse. On one hand, the symptoms associated with MS can make participating in physical activity challenging: disability can hinder mobility and lead to significant pain and fatigue, while overheating during strenuous physical activity is a real risk for people living with MS. On the other hand, limiting physical activity can have negative health consequences and potentially lead to even greater weakness and fatigue in the long-run. Over the past few decades, new researches have uncovered considerable benefits associated with increased physical activity, and perceptions among the MS community have shifted toward encouraging a more active lifestyle.
In addition to being essential to general health and well-being, exercise and physical activity are helpful in managing many MS symptoms.

The Goals of Exercise in MS

The goals of exercise in people living with MS are to improve aerobic endurance, muscular strength and endurance, flexibility, mobility, and to prevent secondary diseases such as cardiovascular disease (CVD) or diabetes 3,4. There is evidence that physical activity and exercise can help maintain the individual's independence, enhance their quality of life, and lead to improved cognitive functioning due to the beneficial effects of physical activity on brain health.

What Types of Exercises are Recommended in MS

Traditional forms of exercise include flexibility training (stretching, range of motion), aerobic training, and progressive resistance training (strength training).     There is no definite evidence showing the superiority of one type of training over the others. The various types of exercise are generally combined in exercise programs based on the individual's needs.

Some Tips for a Successful Workout in MS

• Stay hydrated-cold water will help keep your body temperature low.

• Exercise in a cool room and if outside, exercise at cooler times during the day.

• Remember to stretch afterward.

• No pain no gain should not be your mantra.

• Start low and go slow.

• Consult a medical professional before starting a new exercise routine.

• Prioritize safety to reduce risk of injury.

• Tips for a Safe Workout in MS:

• Take it slow: Always warm up first. Ease into your routine.

• Stay safe: Avoid places with slippery floors, poor lighting, throw rugs, or other tripping hazards. Choose activities that won't make it likely for you to fall, like stationary biking or swimming.

• Know when to quit: If you feel pain or sickness during exercise, stop. If symptoms start to flare up, change or end your routine.

• Find a balance: If you can do vigorous exercise, that's OK, but make sure your workouts don't make you too weak.

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Aerobic Training in MS

Aerobic training in MS patients is more extensively studied than resistance training. During aerobic training, the patients use multiple muscle acts against a low burden with aim of increasing cardiovascular fitness. Aerobic training of low to moderate intensity is effective on cardiovascular fitness, mood and quality of life in multiple sclerosis patients.