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Exercise in people with MS: What recommendations can we give?
Learning objectives
This module was produced during the 2020 quarantine, where filming has been conducted remotely to adhere to social distancing guidelines. For this reason, please forgive a lower production quality than you are used to seeing from us.This module is intended to help you:
- Understand the principles of exercise therapy
- Appreciate the potential benefits of exercise therapy
- Understand the different practical exercise therapies that are relevant to people with different forms of MS
Case study of an active patient with recently diagnosed clinically isolated syndrome
Anna
- Age: 29 years
- Occupation: Banker
Current medication
- No MS medication
Previous clinical history
- 2 months ago: Diagnosed with clinically isolated syndrome
Weekly exercise routine
- Two 30-minute slow-paced runs
Case study based on speaker’s clinical experience
Anna has taken an interest in exercise therapy.
What principles should she adhere to when exercise therapy is prescribed?
Select the correct answer(s)
* Progressive overload is recommendeD 1
† Regular and continuous moderate- to high-intensity efforts is recommended 1
Case study of an inactive patient with recently diagnosed relapsing–remitting MS
Oscar
- Age: 31 years
- Occupation: Dentist
Current medication
- Platform disease-modifying therapy
Previous clinical history
- 4 months ago: Diagnosed with mild relapsing–remitting MS
- 1 relapse — stated that he is feeling anxious about having his next relapse
Current clinical status
- Fatigue
- Visual disturbances
- EDSS score of 3.5
Weekly exercise routine
- No exercise routine currently
Case study based on speaker’s clinical experience
EDSS, Expanded Disability Status Scale
Oscar mentioned that he was feeling anxious about his next relapse. Within what range has exercise therapy been shown to reduce the relapse risk compared with the non-exercise group?
Select the correct answer(s)
* Exercise therapy was associated with 27% lower risk of relapse compared with the non-exercising cohort 1
- Dalgas U. Neurodegener Dis Manag. 2017;7:35–40
- Peluso MAM. Clinics. 2005;60:61–70
- Heine M, et al. Cochrane Database Syst Rev. 2015;9:CD009956
- Dalgas U. ECTRIMS 2019;281844
- Dalgas U, et al. Curr Neurol Neurosci Rep. 2019;19:88
- Kim Y, et al. Am J Phys Med Rehabil. 2019;98:613–21
- Hass CJ, et al. Sports Med. 2001;31:953–64
- Riemenschneider M, et al. MSJ. 2018;24:886–894
- Giovannoni G, et al. Mult Scler Rela Dis. 2016;9:S5–48
- Latimer-Chung, et al. Arch Phys Med Rehabil. 2013;94:1829–36
- MMWR. Centers of Disease Control. 1992;41:001
- Wesnes K, et al. MSJ. 2017;1–8
- Dorans KS, et al. Neurology. 2016;87;1770–6
- Souza PS, et al. Mol Neurobiol. 2017;54:4723–37
- Xie Y, et al. J Neuroimmunol. 2019;328:60–7
- Sandroff BM, et al. Neuropsychol Rev. 2016;26:271–94
- Prakash RS, et al. Brain Res. 2010;1341C:41–51
- Annual RIMS Conference 2019. MSJ;Langeskov-Christensen, M;Submission ID: 23
- Kjølhede T, et al. MSJ. 2018;24:1356–65
- Pilutti LA, et al. J Neurol Sci. 2014;343:3–7
- Bahmani DS, et al. Front Psychiatry. 2019;10:265
What are the key practical characteristics of aerobic/endurance training?
Select the correct answer(s)
* It is many, not few muscle contractions 1
† It is against low-resistance loads, not high-resistance loads 1
‡ It is many, not few muscle contractions and against low-resistance loads, not high-resistance loads 1
- Dalgas U, et al. Curr Neurol Neurosci Rep. 2019;19:88
What level of early-life physical activity was MOST effective at reducing MS risk?
Select the correct answer(s)
* People who performed vigorous physical activity for 3 hours or more per week had a significantly reduced risk of MS compared with those who performed 1 to 2 hours of vigorous physical activity per week 1
† Light physical activity of any frequency did not show an association with MS risk 1
- Wesnes K, et al. MSJ. 2017;1–8
What forms of exercise therapy have been shown to have protective effects on CNS structure?
Select the correct answer(s)
* Progressive resistance training induced an increase in cortical thickness compared with the non-exercising controls 1
† Aerobic exercise had a protective effect on grey matter thickness compared with non-exercising controls 2
- Kjølhede T, et al. MSJ. 2018;24:1356–65
- Dalgas U. ECTRIMS 2019;281844
In the current guidelines, which of these are the recommended types of aerobic activities?
Select the correct answer(s)
* Weight machines are recommended as a strength training activity 1
† Free weights are recommended as a strength training activity 1
- Latimer-Chung, et al. Arch Phys Med Rehabil. 2013;94:1829–36
Congratulations!
You have completed module 4
Links and downloadable elements
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Exercise in people with MS: What recommendations can we give?
There is emerging evidence that exercise therapy has a positive effect on multiple MS outcomes. This module discusses the effect of exercise therapy at different stages of the MS disease course and presents the guidelines for prescription of exercise therapy in people with MS.
Length
10 min course
Job code
NPS-TPE-NP-00164