What is Multiple Sclerosis (MS)? The Benefits of Sports and Recommended Exercises

What is MS (Multiple Sclerosis)?

Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system. In this disease, the immune system mistakenly attacks the myelin sheath that covers nerve cells. Myelin enables the fast and efficient transmission of nerve impulses. Damage to this sheath disrupts communication between the brain and the body.

Multiple sclerosis (MS) typically occurs in young adults aged 20-40 and is two to three times more common in women than men. Symptoms may include fatigue, balance problems, vision problems, numbness, tingling, and muscle weakness.

The Benefits of Exercise for Multiple Sclerosis

While MS patients were previously advised to avoid exercise, it has now been proven that regular physical activity plays a critical role in disease management. Here are the key benefits of exercise for MS patients:

• Muscle Strength and Endurance: Regular exercise prevents muscle atrophy and makes daily activities easier.

• Balance and Coordination: Exercise is beneficial for balance problems, one of the most common symptoms of MS.

• Fatigue Management: Paradoxically, regular exercise reduces fatigue associated with MS.

• Mood and Mental Health: Exercise alleviates symptoms of depression and anxiety.

• Cardiovascular Health: Protects heart and blood vessel health and prevents secondary complications.

Exercises Recommended for MS Patients

The most effective and safest types of exercise for people with MS are:

1. Water Exercises (Aqua Therapy)

Water supports the body and reduces the load on the joints. The buoyancy of water facilitates movement, and cool water is ideal for patients with heat sensitivity.

2. Walking and Cycling

Low-intensity aerobic exercises help manage fatigue while protecting cardiovascular health. Stationary bikes are a safe alternative for patients experiencing balance problems.

3. Stretching and Yoga - Pilates

Stretching exercises reduce muscle stiffness (spasticity). Yoga and Pilates, on the other hand, both increase physical flexibility and are effective in stress management.

Pilates and Multiple Sclerosis

Pilates is one of the most recommended exercise methods for people with MS. Here's why:

The Specific Benefits of Pilates for MS

• Core Strengthening: Pilates strengthens abdominal and back muscles, improving posture and balance.

• Controlled Movement: Slow and controlled movements improve neuromuscular coordination.

• Flexibility: Pilates increases range of motion by reducing spasticity.

• Breathing Exercises: Conscious breathing increases oxygen intake and reduces stress.

• Low Impact: Enables strength gains without putting strain on the joints.

Pilates Recommendations for MS Patients

1. Work with a Pilates instructor who is experienced in MS.

2. You can start with reformer pilates instead of mat pilates; the machine makes the movement easier.

3. Start with 2-3 sessions per week, increasing as your body responds.

4. When you feel extremely tired, rest; the principle of 'rest your body' is very important.

5. Exercise in cool environments; heat sensitivity symptoms may worsen.

I would also like to share the summary study prepared by our physiotherapist and Pilates instructor, Nagihan Ela Kayabaşı.

Multiple Sclerosis (MS)

Multiple sclerosis (MS) is a disease that damages the myelin sheath (the lining of nerve fibers) in the central nervous system (brain and spinal cord).

(insulating layer) of the immune system damages the inner lining of the body, resulting in a chronic, neurological condition.

It is a disease. Myelin loss disrupts signal transmission, leading to loss of neurological function. MS attacks

It progresses with flare-ups and remissions.

Pathology: Autoimmune reaction → myelin sheath and axon damage → impaired nerve conduction

It is 2-3 times more common in women.

It usually starts between the ages of 20 and 40.

Key Symptoms: Fatigue, Heat sensitivity, Spasticity, Ataxia/Balance disorder.

Neuropathic Pain.

Objectives of the Rehabilitation and Exercise Program:

To increase mobility (walking, transfers).

Managing spasticity.

To improve balance and coordination.

To reduce fatigue.

Rehabilitation Principles

• Attack phase: Rest + ROM exercises

• Remission period: Functional training (transfer, ambulation)

• Progressive phase: Compensatory techniques (wheelchair adaptation)

Exercises:

1. Aerobic Exercises:

• Walking: 10-30 minutes on flat ground (stop at the point of fatigue).

Underwater exercises: Provide the opportunity for movement without resistance.

2. Balance and Coordination:

• Standing on one leg: Begin by holding onto a support.

Tandem walking: Walking heel-to-toe.

3. Resistance Exercises:

Thera-band for the upper extremities: For shoulder and arm muscles.

Mini squats: Strengthen knee extensors.

4. Flexibility:

Stretching: Hamstring, gastrocnemius (30 sec x 3 repetitions).

5. Breathing Exercises:

Diaphragmatic breathing: Reduces stress and fatigue.

Compatible Devices:

• Walker or cane-walker: For those with balance problems.

• AFO (Ankle Orthosis): For foot drop.

• Electrical stimulation (FES): To activate the tibialis anterior muscle.

Treatment Modalities

1. Physical Modalities:

• Cold application: Reduces spasticity.

TENS: For pain control.

2. Robotic Rehabilitation: Lokomat: A robotic system for gait training.

Contraindications

1. Aerobic exercise during active fever

2. Passive stretching in severe spasticity.

3. Sudden postural changes in orthostatic hypotension

Multidisciplinary Approach

• Neurologist: Immunomodulatory therapy

• Urology: Management of bladder dysfunction

• Psychologist: Depression/anxiety intervention (Depression develops in 40% of patients)

It should not be forgotten!

We thank our physiotherapist for her contributions. Instagram: @nagihan_elaa

Important Note: Always consult your neurologist before starting any exercise program. A personalized program should be created based on the stage of your condition and your symptoms.

Conclusion

Although living with MS is challenging, regular exercise and holistic approaches, especially Pilates, can significantly improve quality of life. With the right guidance and patience, people with MS can lead strong, flexible, and active lives. Remember: Every movement is a step towards your health!