A new study changes the traditionally held view that MS patients shouldn't engage in physical activities, writes SYLVIA THOMPSON
UNTIL RECENTLY, people with Multiple Sclerosis (MS) were advised not to take up physical activities that they found tiring.
However, the results of a new study of an exercise programme co-ordinated by the MS Society of Ireland has radically changed that view.
“We now know that it’s important for people with MS to remain physically active as much to preserve and even improve their abilities as to combat the harmful effects of inactivity – stiffness, muscle loss, reduced flexibility, etc,” explains Aidan Larkin, the co-ordinator of Getting the Balance Right exercise programme for people with MS.
The programme was initiated by the MS society after a survey found that physiotherapy and exercise were what people with MS most wanted. “We found that physiotherapy and exercise-related programmes were the top priority in terms of services required which were not widely available either through the HSE or from MS Ireland,” says Larkin.
More than 1,600 people have availed of group and one-to-one physiotherapy, yoga, instructor-led gym classes, t’ai chi and hydrotherapy since the programme began 18 months ago.
Furthermore, MS Ireland teamed up with the Department of Physiotherapy at the University of Limerick (UL) to investigate the specific effects of various forms of exercise.
Dr Susan Coote, chartered physiotherapist and lecturer in physiotherapy at UL, was the principal investigator of the study. “We found that for people with MS who used a stick, being physically active reduced the impact of MS and also reduced their fatigue,” explains Coote.
“We also found that people in this category had similar improvements whether they had one-to-one physiotherapy or group physiotherapy.
“Traditionally, exercise was viewed as wrong for MS patients, but there is a growing body of evidence that suggests there is no increase in risk of relapse from exercise,” she says.
In fact, the study found that those who didn’t participate in exercise programmes had a greater risk of relapse and had significant reduction in their balance.
Coote adds that while those who participated in gym classes, physiotherapy or yoga all showed “reduction of impact of their MS and reduction in fatigue”, only those who participated in gym classes or physiotherapy also showed an improvement in their walking ability.
In other words, those who did yoga didn’t show the additional improvement in their walking ability.
Anne-Marie Hayden (26) had experienced several severe symptoms of MS before she participated in the Getting the Balance Right exercise programme.
“I had no bladder or bowel control. I was a wheelchair user. I had difficulty with my swallowing and speech, and I had a constant tremor in my leg,” she explains.
Hayden started one-to-one physiotherapy sessions with chartered physiotherapist Garett Wright in August. “Basically, within three weeks, I started to improve. The tremor in my leg is gone. I began making steps and now I can walk unaided. I have regained bladder and bowel control, and I am off all medication,” she explains.
Wright says the improvements shown by Hayden “defy logic”. “When I first saw her, she had a lot of uncontrolled movement and was in a wheelchair. Within a few weeks, her balance and bladder control had improved and she was walking,” explains Wright, who devised the exercise programme for Hayden in conjunction with an oscillating plate which sent vibrating movements throughout her body.
And while it’s important to say that not everyone shows such radical improvements following exercise, the positive results of the programme has prompted the MS society to suggest a new model for providing physiotherapy for people with MS.
“We have developed a new group of physiotherapists with an interest in MS and we’d like physiotherapists to upskill informal carers who could deliver a physiotherapy programme to MS patients between sessions with the physiotherapist. That way, we could have the available number of physiotherapy sessions spaced out throughout the year together with the back-up programme,” explains Larkin.
Meanwhile, the Getting the Balance Right exercise programme is still available throughout the State to anyone with MS who would like to avail of it.
Tips for starting to exercise
1. Start gradually. Don’t expect too much too quickly.
2. Take regular breaks.
3. Ask for advice if you are unsure of your limits.
4. Respect your own pace.
5. Don’t exercise during MS attacks.
6. Opt for exercise that develops endurance more than physical strength.
7. Start with 10 minutes a day, four or five times a week. The more often you exercise is more important than how long you exercise for.
8. Choose a time of day when you feel at your best.
9. Set realistic goals
10. Start to exercise as soon as possible after receiving your diagnosis of MS
** Adapted from MS and Fitnesswhich together with Everybody Stretchare guides to exercise for people with MS and are available on www.ms-society.ie
** The MS helpline at 1850-233233 is open Monday-Friday, 10am-5pm, and Tuesday and Thursdays from 6.30pm-9.30pm, mshelpline@ms-society.ie
