Physical Activity (PA) Intervention for Multiple Sclerosis

With the current state of MS therapy, many patients can enjoy a normal life and minimize the disability they experience. If, however, the goal is complete rehabilitation of patients with MS, a cure is most likely impossible.

MS is an inflammatory disease typically affecting the optic nerve and brain. Both the brain and optic nerve can be affected. The most common symptoms in MS are worsening vision loss followed by brain problems. MS has several ways of looking at symptoms. \n

A precise definition is needed to classify the etiology of MS. It is well established that most MS patients exhibit oligoclonal bands that are not found in healthy patients with otherwise similar clinical and radiological features. The underlying mechanisms involved are unknown and are the focus of intense research.

The presentation of MS is variable and depends on the type of disease process which is occurring in the CNS. The most common signs and symptom are numbness, weakness, pain and bladder dysfunction which may all occur at any time. Neurological examination of the entire body is necessary to make an accurate diagnosis.

There is little evidence from systematic reviews about the treatment of multiple sclerosis and some of the reported treatments (such as antiviral agents and immunosuppressants) have only been reported in case reports or pilot studies. The use of corticosteroids for symptomatic relief, and their potential for inducing more serious side effects (e.g. diabetes insipidus) should be considered.

About 12 people are diagnosed with MS annually in the United States. This number is consistent with a current estimate of approximately 10,000 active MS patients in the U.S. at any given time.

In summary, the major side effects of increased PA included increased fatigue, muscular cramps, and soreness. Regular exercise may be more appropriate for patients with low mobility deficits. Moderate exercise has a beneficial impact on sleep quality, depression, and fatigue, and the effect is possibly mediated by sleep-related factors. Further research is needed to determine the most effective duration of PA for a particular population and the optimum dose of exercise.

This is a relatively new condition that is slowly becoming recognized and thus the average age for new patients is higher than originally thought. There are no reliable sources confirming the average age in various studies. The age of diagnosing multiple sclerosis has also changed: In a Danish study, patients who were younger at diagnosis (21.5 yr versus 27.9 yr) experienced a shorter interval until conversion (mean interval 4.8 yr) than the population-based cohorts (mean interval 6.6 yr). On average, patients younger than 36 yr at diagnosis experience a shorter interval between first symptoms and a diagnosis, and this is even more pronounced in the female group.

PA intervention for MS patients leads to a significant improvement in various HRQoL domains. A more intensive PA intervention may have a broader effect on HRQoL, which may affect HRQoL and/or participation behaviour in an integrated rehabilitation setting.

PA may reduce the risk of developing MS or NIND but there is a need to implement large-scale intervention studies on long-term consequences for long-term safety of an early/early PA intervention.

This small pilot study suggests that PA intervention does not improve symptoms. Future studies using more robust and rigorous trial designs are indicated, incorporating the evaluation of PA type, duration, intensity and duration of intervention, duration of follow-up and the evaluation of a physical exercise intervention in the natural exercise environment.