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IMPORTANCE OF EXERCISE FOR MULTIPLE SCLEROSIS

I work with many people who suffer medical conditions, everything from heart conditions to under or over active thyroids. A large number of people I train suffer with MS (multiple sclerosis). I’ve written this article with them in mind, hopefully it will give you an insight to the illness and provide some useful generic information.

 

As with a range of medical conditions, exercise plays a fundamental part of well being for MS sufferers.

 

So what is MS?

 

Multiple sclerosis is a condition that affects the central nervous system. The extent of the effects varies from person to person. To understand MS we need to understand the central nervous system.

 

A substance called myelin protects the nerve fibers in the central nervous system, which helps messages travel quickly and smoothly between the brain and the rest of the body.

 

In an MS patient, the body’s immune system designed to protect the body from infections, mistakes the myelin for a foreign object and attacks it.  It can destroy or damage the protective myelin coating leaving the nerve exposed and often scarred. In many cases it actually causes nerve damage and the messages to and from the brain to various parts of the body cannot be sent or received. It’s this nerve damage that causes the severe disability over time. This is why the effects vary from person to person, depending on the area of the central nervous system that has been damaged and the parts of the body the specific nerves serve.

 

MS affects about 100,000 people in the UK most diagnosed between the ages of 20-40. There are no commonly known causes of MS and its not thought to be hereditary however, its thought to be a mixture of environment and genetics.  It seems to be more prevalent in the areas that are further away from the equator. It’s practically unheard of in places such as Malaysia or Ecuador. It is common in UK, Canada, and New Zealand.

 

 

A lack of Vitamin D is thought to be a factor as are smoking, being overweight and viral infections. Poor diet is also a factor to consider, as the main symptoms are the attack on the immune system, which may already be low due to a poor diet. There is no known cure for the illness but the condition can be managed with a combination of medication, exercise and diet.

 

Everyone with MS, regardless of disability require regular physical activity. Lack of exercise can lead to major problems including joint contractures, increased spasticity, heart problems and constipation. A good exercise program not only prevents problems, but also increases a sense of well-being.

 

 

 

A good exercise program can be broken down into 5 categories;

 

·      Flexibility

·      Strengthening

·      Cardio vascular workout

·      Balance and coordination

·      Range of motion

 

 

 

Flexibility is moving the joint through its full range and stretching the muscle and tendon to its full length. These activities decrease muscle tightness and prevent loss of range of motion, which may occur when activity levels are decreased, at times of weakness or spasticity. With decreased flexibility, joint contractures can occur. These can be painful and may also limit the range of motion.

 

Strengthening involves increasing the power of the muscle and maintaining muscle mass to prevent atrophy; the shrinking of the muscle. A wide range of equipment and activities can help to achieve and maintain muscular strength. These range from weight training, resistance bands, using own body weight and working under the force of gravity or oven water.

 

Cardio vascular workouts help to improve the heart and lung functions. It also helps to increase the amount of activity and exercise one can do. This in turn helps to maintain blood sugars, cholesterol levels and body fat. Walking, swimming cycling or any activity, which increases heart rate, is good for this.

 

Balance and coordination helps to maintain the efficiency of a movement and reduces unnecessary energy expenditure. Activities can be performed in water, on land, sitting in a chair, using a stability ball and various other things.

 

Range of motion exercises are designed to improve or maintain the extent to which a joint can move. There are two main ways of achieving this;

·      Passive range of motion; this involves the assistance of a therapist or trainer manipulating the joint to its potential.

·      Active range of motion; this is how far you are able to move the joint without assistance.

 

Along with exercise, nutrition plays an important part for people suffering with MS.  Getting all the nutrients will help the body to work to its full potential.

A good diet plan will ensure that you receive the correct amounts of;

 Protein; for growth, repair and maintaining muscle structure

Carbohydrates, for energy

Fiber to promote efficient digestion and bowl function

Vitamins and minerals, for numerous processes in the body, including tissue repair, bone strength and the absorption of other nutrients

Fluids; required for optimum working of the body. Water carries nutrients around the body and is used in the various chemical processes happening in our cells.

Not only is it important to eat the right foods, but also the amount of food in terms of calories you consume is equally important. The generic quantities for men and women are 2500 calories for men and 2000 calories for women. This assumes that you live an active lifestyle. For people who suffer disabling conditions such as MS and are predominantly wheelchair bound, the calorific intake is even more important. The body would require roughly 600 calories less per day than the average person. My recommendation would be around the 1800 calories for men and 1500 calories for women.  This is only a guide and should be taken as such. The exact amount would also depend upon your height, how fast your metabolic rate is, and other medical complications and allergies.

 

Special diets for MS

Although there is no clear evidence that a special diet has any significant benefit, some people feel that it has made a difference. The most recognized of these diets include the SWANK diet.

Swank Diet is perhaps the best-known diet associated with MS. It is named after Dr Roy Swank, who developed the diet in the 1940s. This diet involves restricting the amount of fat you can eat: no more than 15 g of saturated fat a day, and between 20-50 g of unsaturated fat. With the swank you will also need to limit your intake of red meat and oily fish, although you can eat as much white fish as you like.

Research into this diet shows no definitive benefits. Although a number of studies have been carried out, they have not generally been well designed. They also had very high dropout rates, so without knowing what happened to the people who dropped out of the study it is difficult to get a conclusive result. However, following this or a similar diet is not considered to be harmful in any way or bad for you.

Cutting down on meat and dairy foods to reduce saturated fats might leave a shortfall in protein, so it’s important to find alternative sources such as fish, beans and pulses.

Cod-liver oil has a blood-thinning effect and should be taken with caution if you take aspirin, anti-coagulant medications (for example, warfarin) or have a bleeding disorder.

If you have diabetes you should also speak to your doctor before taking cod-liver oil. This diet can be low in energy and unless care is taken to maintain energy intake, it may not be suitable if you have high-energy needs or are underweight.

With adequate exercise, nutrition and controlled medication, the condition can be managed and the debilitating effects may be delayed. I will be posting an separate article highlighting a range of exercises that can be done either sitting down or within the confinements of a wheelchair.

 

 

 

 

 

 

 

 

 

 

 

 

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