New insights on exercise therapy in MSThursday, October 03, 2013, 14:35 - 14:55
State-of-the-art exercise therapy in MSU. Dalgas (Aarhus, DK)
For many years patients with multiple sclerosis (MS) was recommended to avoid exercise therapy (ET). This advice was given because it was noted that ET could worsen symptoms and induce fatigue. Today we know that the worsening of symptoms is a temporary phenomenon and that ET is safe with minimal risk of adverse events and side effects. Furthermore, ET has a broad range of beneficial effects covering both physiological and psychological aspects, which often improves health and quality of life. ET covers a number of different exercise modalities ranging from resistance training (RT) at the one end to aerobic training (AT) at the other end. Both RT and AT are safe, and induces numerous beneficial effects, that do, however, differ markedly in some respects. Despite the numerous beneficial effects most studies that include a follow up period have shown, that when MS patients leave the study setting the attained effects tend to disappear, strongly suggesting that long-term adherence is a major problem that needs to be addressed further. Also, research focusing on barriers and facilitators towards a more active physical lifestyle in MS patients, needs more attention in future studies.
Another important issue is that some researchers have started to suggest that ET (or physical activity) might have the potential to have an impact on MS pathology and thereby slow down the disease process. Despite some evidence supporting the possibility of a disease-modifying potential of ET, the strength of the existing evidence limits definite conclusions on this important aspect.
Taken together ET is one of the most promising non-pharmacological treatments in MS, being safe and having numerous beneficial physiological and psychological effects.
1. Dalgas, U, Stenager, E, Ingemann-Hansen, T. Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training. Mult Scler 2008 14: 35-53.
2. Asano, M, Duquette, P, Andersen, R, Lapierre, Y, Mayo, NE. Exercise barriers and preferences among women and men with multiple sclerosis. Disabil Rehabil 2013 35: 353-361.
3. Dalgas, U, Stenager, E. Exercise and disease progression in multiple sclerosis: can exercise slow down the progression of multiple sclerosis? Ther Adv Neurol Disord 2012 5: 81-95.
UD has received research support, travel grants and/or teaching honorary from Biogen Idec, Merck Serono and Sanofi Aventis. UD further serves as PI for the ongoing Biogen sponsored ACTIMS study.