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Wednesday, December 1, 2010

Maintaining an active lifestyle essential for people living with MS

NOVEMBER 30, 2010
"Exercise improves the fatigue level, probably better than any drug out there," Stewart says. "Tai chi and yoga, for instance, have a markedly positive impact on patients' balance and on improving their level of fatigue."
Photograph by: Shaughn Butts, Edmonton Journal

Multiple sclerosis is "the single biggest disabler of young, healthy adults," says Edmonton neurologist and University of Alberta associate clinical professor Dr. Brad Stewart. "Medication can cut down on relapses. Some drugs will cut down on disability. Some will have an impact on quality of life."

But Stewart, like many experts, says exercise also plays a crucial role in improving life for people with MS.

"Exercise improves the fatigue level, probably better than any drug out there," Stewart says. "Tai chi and yoga, for instance, have a markedly positive impact on patients' balance and on improving their level of fatigue."

"Exercise is good for all of us and is specifically good for MS patients," says neurologist Dr. Virender Bhan, an associate professor and director of the MS research unit at Dalhousie University, who has cared for MS patients for two decades.

"We recommend that our patients should be as active as possible, keeping in mind that they need to be safe, whatever the activity," says Trudy Campbell, one of only three nurse practitioners in Canada specializing in working with multiple sclerosis patients.

"Exercise, learning strategies to cope with stress, adequate nutrition, maintaining an ideal body weight and family support all play a role in living with MS," she says.

As part of her research projects, Memorial University postdoctoral fellow and physiotherapist Michelle Ploughman worked with numerous older individuals who have had MS for more than 20 years.

"They talked about what they have done to manage their condition and their quality of life now," she says. "I met people in their seventies and eighties who were still contributing to their community, providing telephone support to others with MS and remaining as active as possible. Their lives were not always rosy, but certainly the people who were doing best followed the trend of resilience, taking charge and staying active."

Bhan says that numerous studies indicate the value of any kind of exercise for MS patients. "The type of exercise does not seem to make any difference," he says. "In one study, the groups that did aerobic exercise or worked with weights did equally well and better than the control group. The message is that patients don't have to worry about the type of exercise. Any exercise works."

Balance and time management are also very important for people with MS, says Stewart. "I tell my patients if you're having a bad day, take it easy. If you're having a good day, don't try to make up for all the bad days of the past month. Instead, take an hour or two to go out for dinner and enjoy yourself while you're feeling good."

He adds that getting the appropriate amount of sleep, taking naps and pacing themselves are also extremely important for people with MS; so are managing any other concurrent diseases "aggressively" and maintaining a generally healthy lifestyle. He warns against smoking, for example. "If you have MS and you smoke, you are really doing yourself a disservice. People who smoke tend to have more attacks and more relapses."

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Tips for safe exercise with multiple sclerosis
• Always warm up before beginning the exercise routine and cool down at the end.
• If you plan to work out for 30 minutes, start with 10-minute work out sessions and work your way up.
• Work out in a safe environment; avoid slippery floors, poor lighting, throw rugs and other potential tripping hazards.
• If you have difficulty balancing, exercise within reach of a grab bar or rail.
• If you feel sick or are in pain, stop.
• Select an activity that you enjoy, e.g. water aerobics, swimming, tai chi and yoga.
• MS symptoms may worsen when body heat rises, so don’t exercise during the hot time of the day and drink plenty of cool fluids.
Source: WebMD,