Want to take charge of a life with Multiple Sclerosis? START EXERCISING! Preferably both strength and cardiovascular training.
We now know exercise helps with Multiple Sclerosis by reducing fatigue, spasticity, endurance, overall quality of life, balance, and depression.
So if you could have control over all these symptoms, what impact would that bring to your life?
Exercise is so important for people with Multiple Sclerosis that the guidelines are the same as the general public, in fact strength training is encouraged even more for people with Multiple Sclerosis. And don’t worry. People with multiple sclerosis get the same benefits with strength training as everyone else, except probably more so.
Moving better is empowering, especially when living with MS. If you want to know how to improve many of your symptoms, various types of regular exercise help with fatigue(1)(2)(3)(4)(5) spasticity,(1) endurance,(1) quality of life,(1)(5) balance,(1)(2) and reduced depression.(2) This is why at Optimove we strive to get all of our clients with MS back to exercise or to optimize the exercise program they are already doing.
Multiple Sclerosis & Falls
Half of all individuals with MS will fall in any 6 month period,(6)(7) and your age may have nothing to do with it.(8) Most individuals with MS are afraid of falling, and as a result, over 80% of those afraid of falling will limit their life activities.(9)
But there is a disconnect in our healthcare system. A very small percentage of those with MS who have fallen will have received any type of fall assessment from a rehabilitation professional, even after the fall.(10)
Since walking slow,(8) using a device,(6)(8) perceived deterioration,(6) and actual physical debility(8) are associated with falls for people with MS, these are all areas that can be addressed specifically based on the individual. Individualized treatment is especially important since fall risk is not as easily tested in MS compared to other populations.(6)
At Optimove we holistically take into consideration all aspects of our client’s reality which may increase fall risk.
Back To Exercise & Moving With MS
The amount and severity of MS symptoms someone is experiencing is strongly associated with their fear of falling.(9) Fortunately, general exercise helps with these symptoms.(1-5) Since perceived decline,(6) actual physical debility,(8) and use of devices(6)(8) are associated with fall risk in MS, that is all the more reason to improve our clients’ physical abilities, independence with moving, and progress them to an exercise program so they can continue to become stronger, more fit, independent, and thriving.
Inner Ear Balance (Vestibular) & MS
Inner ear balance (Vestibular) disorders are quite common with MS, possibly greater than 85% of those in the early stages.(11) Despite this high rate of vestibular dysfunction in MS, a smaller percentage of those people will have dizziness (Less than 20%).(11)
The exact reason for this vestibular dysfunction is in most cases not necessarily due to specific lesions in the central nervous system.(11)(12)
So…
All this means a lot of the problems you may be experiencing with dizziness, balance, and vertigo with MS may be treatable with specific inner ear balance exercises and treatments (Vestibular Rehabilitation).(12)(13)(14) Vestibular rehabilitation can even help with fatigue.(14) Most directly, this specific type of exercise-based therapy produces good results in balance with people with MS(13) which can reduce fall risk.
When actual vertigo is the symptom (spinning sensation), the cause most of the time is the same as those without MS (Benign Paroxysmal Positioning Vertigo, AKA BPPV, AKA rocks in the head in the wrong spot).(12)(15) This means that in these cases, the vertigo is easily treatable.(12)(16)
References
1) Tarakci E, Yeldan I, Huseyinsinoglu, BE, Zeenginler Y, Eraksoy M. Group exercise training for balance, functional status, spasticity, fatigue, and quality of life in multiple sclerosis: a randomized controlled trial. Clinical Rehabilitation. 2013;27:813-822
2) Ahmadi A, Arastoo AA, Nikbakht M, Zahednejad S, Rajabpour M. Comparison of the Effect of 8 weeks Aerobic and Yoga Training on Ambulatory Function, Fatigue and Mood Status in MS Patients. Iranian Red Crescent Medical Journal. 2013;15:449-454
3) Heine M, van de Port I, Rietberg MB, van Wegen EE, Kwakkel G. Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst Rev. 2015;11(9).
4) Asano M, Finlayson ML. Meta-Analysis of Three Different Types of Fatigue Management Interventions for People with Multiple Sclerosis: Exercise, Education, and Medication. Multiple Sclerosis International. 2014.
5) Dalgas U, Stenager E, Jakobsen J, Petersen T, Hansen HJ, Knudsen C., et al. Fatigue, mood and quality of life improve in ms patients after progressive resistance training. Multiple Sclerosis.2010;16:480-490.
6) Gunn HJ, Newell P, Haas B, Marsden JF, Freeman JA. Identification of Risk Factors for Falls in Multiple Sclerosis: A Systematic Review and Meta-Analysis. Phys Ther. 2013;93:1-31.
7) Finlayson ML, Peterson EW, Cho CC. Risk factors for falling among people aged 45 to 90 years with multiple sclerosis. Arch Phys Med Rehabil. 2006;87(9):1274-1279.
8) Gianni C, Prosperini L, Jonsdottir J, Cattaneo D. A systematic review of factors associated with accidental falls in people with multiple sclerosis: a meta-analytic approach. Clin Rehabil. 2014;28(7):704-716.
9) Peterson EW, Cho CC, Finlayson ML. Fear of falling and associated activity curtailment among middle aged and older adults with multiple sclerosis. Multiple Sclerosis. 2007;13:1168-1175.
10) Fritz NE, Eloyan A, Baynes M, Newsome SD, Calabresi PA, Zackowski KM. Distinguishing among multiple sclerosis fallers, near-fallers and non-fallers. Multiple Sclerosis and Related Disorders. 2018;19:99-104.
11) Zeigelboim BS, Arruda WO, Mangabeira-Albernaz PL, Iorio MC, Jurkiewica AL, Martins-Bassetto J, et al. Vestibular findings in relapsing, remitting multiple sclerosis: a study of thirty patients. Int Tinnitus J. 2008;14(2):139-145.
12) Frohman EM, Zang H, Dewey RB, Hawker KS, Racke MK, Frohman TC. Vertigo in MS: Utility of positional and particle repositioning maneuvers. Neurology. 2000;55:1566-1568.
13) Ozgen G, Karapolat H, Akkoc Y, Yuceyar N. Is customized vestibular rehabilitation effective in patients with multiple sclerosis? A randomized controlled trial. European Journal of Physical and Rehabilitation Medicine. 2016;52(4):466-478.
14) Hebert JR, Corboy JR, Manago MM, Schenkman M. Effects of Vestibular Rehabilitation on Multiple Sclerosis-Related Fatigue and Upright Postural Control: A Randomized Controlled Trial. Phys Ther. 2011;91:1166-1183
15) Frohman EM, Kramer PD, Dewey RB, Kramer L, Frohman TC. Benign paroxysmal positional vertigo in multiple sclerosis: diagnosis, pathophysiology and therapeutic techniques. Multiple Sclerosis. 2003;9:250-255.
16) Bhattacharyya N, Gubbels SP, Swartz SR, Edlow JA, El-Kashlan H, Fife T, et al. Clinical Practice Guildeline: Benign Parosysmal Positional Vertigo (Update). Otolaryngology-Head and Neck Surgery. 2017;156(3S):S1-S47.
