Benefits, safety, and prescription of exercise in persons with multiple sclerosis

Abstract

Exercise represents a behavioral approach for the restoration of function and management of symptoms among persons with multiple sclerosis (MS). The current paper provides a review on the topic of exercise in MS and is separated into four sections. The first section defines exercise and related constructs. The second section summarizes evidence for the benefits of exercise in MS based on literature reviews and meta-analyses. The third section focuses on the safety of exercise in MS based on the reporting of relapses and other adverse events, and the last section describes guidelines for exercise. The paper concludes with a discussion of major limitations with the existing body of research and highlights some of the pressing areas for future research on exercise in MS.

Keywords::

• depression
• exercise
• fatigue
• fitness
• multiple sclerosis
• quality of life
• rehabilitation
• symptoms
• walking

Key issues

• Exercise is a type of leisure-time physical activity behavior that can result in improvements in health-related fitness.

• There is strong evidence that exercise is associated with benefits for aerobic and muscular components of fitness, symptoms of fatigue and depression, walking mobility, and quality of life in multiple sclerosis (MS). There is significant, but weaker evidence for a benefit of exercise on balance.

• Exercise is safe considering that it does not increase the rate of relapses reported in randomized controlled clinical trials, and the rates of other adverse events such as musculoskeletal injuries are quite low in MS.

• Recent guidelines have been provided for prescribing the appropriate amount of exercise for maximizing the benefits of exercise in persons with mild and moderate MS-related disability.