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Sport and MS

What kind of sport can I do? Which sport might have a negative impact on my MS? These questions often come in discussion with people with MS. Here are some answers to these and other questions.


What do studies of sports and MS tell us?

It used to be assumed that sport had a negative impact on the course of MS because of a sensitivity to heat. An increase in body temperature of 0.5°C causes a slowing and/or blocking of the nerve impulse conduction in demyelinated fibres that may result in a temporary worsening of MS. However, this idea is not supported by various studies.(1-4) Nowadays, the mainly benefical effects of exercise are stressed. Recent studies show an improvement of fitness as well as psychological well being.


What do MS patients need to know?

The temperature regulation of people with MS is often affected. This can sets limits to sporting activities. You should also cool off after sport with a swim or a long cool shower.

Every sufferer should find his or her tolerance of sporting activity.

With visual problems, fast moving types of sports, such as ball games, are best avoided. It is possible to continue with sporting activities during a relapse if you do not overexert yourself. However, it is important for people with MS to refrain from overdoing it and risking injury. Do not compare your activities with conventional ideas of what is sporty or correct technique. Participation in competitive sports depends on the degree of physical impairment. Those endurance sports that cannot be broken off at any time are less suitable, such as long distance swimming, high-altitude mountain climbing or ski touring in difficult terrain.


What can the MS patient get out with sport?

As with healthy people, improvements in cardiac function and circulation as well as a beneficial effect on body weight are found. Also, many symptoms of MS are improved by the maintenance of mobility.


Selected studies on the effect of sport on people with MS

Sport in people with MS aims to promote coordination and balance. In moderate to severe disability, and those who suffer from extreme sensitivity to heat, exercise in water can be particular useful. The support of the water makes movements possible which are no longer achievable outside of water.

• Training in groups, instead of alone at home, definitely made exercise more effective. The opportunity for increased social interaction helps to encourage an improved sense of well-being. Improved walking ability, mobility and bladder/bowel functions are also found.(1)

• Strength and fatigue in people with MS were tested during a 10-week fitness programme in water. Arm and leg function exhibited a clearly measurable improvement.(2)

• A 15-week study on the impact of fitness training on the quality of life of people with MS indicated a significant improvement in muscle power and vital capacity of the lungs after training 3 x 40 minutes per week, independent of the degree of disability. Different tests determined the impact of the disease on the mood and the degree of fatigue, as well as a neurological point scale EDSS. Improvement was indicated in shoulder, elbow, and knee mobility, strength in the arms and legs, cardiovascular function as well as social interaction. It was striking that a slower onset of fatigue coincided with better bodily function.(3)

• In therapeutic (passive)riding, which aims at reducing tension and pain in the hip joint and back, the movement of the horse has a positive effect on the rider. Passive riding should not be confused with conventional riding, where the rider directs the horse. A Canadian study showed that the participants had improved walking speed, balance and mood after 9 weeks of training.(4)

The results provide evidence that sporting activities have a similar positive impact on people with MS as in those without the condition.


In summary

• Do moderate but regular sport activities

• Work out an individualised fitness training programme adjusted to your own situation, alternating with relaxing techniques

• Avoid exercises which require a great deal of effort with a risk of overstraining and injury

• Counteract spasticity and muscle shortening with stretch training

• Get the most out being in a wheelchair - for instance concentration and mobility can be promoted by practising archery


References

1 Petajan JH, White AT. Recommendations for physical activity in patients with multiple sclerosis. Sports Medicine 1999;27(3):179-191. 2 Gehlsen GM, Grigsby SA, Winant DM. Effects of an aquatic fitness program on the muscular strength and endurance of patients with multiple sclerosis. Physical Therapy 1984;64:653-657. 3 Petajan JH, Gappmaier E et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Annals of Neurology 1996;39:432-441. 4 Mackay-Lyons M, Conway C, Roberts W. Effects of therapeutic riding on patients with multiple sclerosis: a preliminary trial in horseback riding. Physiotherapy-Canada 1988;40(2):104-9.