Recherche en gérontologie et en gériatrie

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Evidence Based Therapeutic Exercise Recommendations for Patients with Multiple Sclerosis: A Physical Therapy Approach

Paul K Canavan

Multiple Sclerosis (MS) is a chronic demyelinating disease of the central nervous system affecting over a million people worldwide. The demyelinating process begins when inflammatory T cells of the immune system attack the oligodendrocytes after infiltrating the blood-brain barrier, creating a cascade effect of neurological symptoms. MS presents itself through physical symptoms including fatigue, depressed mood and motor deficits. Current research has shown promise in using exercise intervention to curb the symptoms of this autoimmune disease. This brief review evaluated studies that utilized exercise to decrease fatigue, improve quality of life (QoL), and improve ability to perform activities of daily living. Assessments utilized to examine efficacy of exercise include the Fatigue Severity Scale, Multidimentional Fatigue Inventory-20, and the Major Depression Inventory. These tests provide both an objective and subjective view of the MS disease process. The purpose of this review is to provide information related to resistance exercise recommendations for physical therapists to use as a guide when prescribing exercise interventions to patients with MS. The training program aims to reduce mobility related impairments, decrease fatigue and improve QoL in individuals with MS. After review of this article the reader should ascertain a newfound comfort and knowledge for delivering progressive resistance training to persons with MS. This guide provides both novice and intermediate-advanced recommendations for exercise. The exercise recommendations are indicated for patients with less than or equal to a 6.0 on the Expanded Disability Status Scale. MS patients should consult a physician before actively engaging in any exercise program.