Canada has one of the highest rates of Multiple Sclerosis (MS) in the world. Over a decade ago, there was a prevailing thought that MS patients should avoid physical activity lest it aggravates some of the symptoms. As numerous studies have shown, exercise – contrary to the old perception – can benefit the patients tremendously. For that reason, First Class Personal Training based in Toronto is offering customized MS fitness programs.
Multiple Sclerosis (MS)
MS is an inflammatory neurological disease of the central nervous system that affects the brain, spinal cord and optic nerves. There are over 2.8 million people worldwide affected by this autoimmune disabling neurological condition. According to the Public Health Agency of Canada, over 98 thousand people lived with this condition in 2011. This figure may rise to over 133 thousand by 2031.
To date, researchers have yet to understand the cause of MS. They do know what happens when it occurs. Primarily, it attacks the protective covering of the nerves called myelin, thereby disrupting the transmission of nerve impulses through the nerve fibres.
Once the damage becomes substantial, scar tissue replaces the myelin. Consequently, the nerve fibres also get damaged due to the disruption of the nerve impulses.
Symptoms of multiple sclerosis:
- Balance affected by dizziness or vertigo
- Bladder dysfunction
- Bowel dysfunction (mainly constipation but also include diarrhea and incontinence)
- Cognitive impairment (especially short-term memory)
- Depression
- Fatigue
- Gait (difficulty in walking due to muscle weakness, spasticity, problems with balance and coordination, fatigue, and pain)
- Optic neuritis
- Pain
- Paroxysmal symptoms
- Sensory disturbance, numbness or tingling
- Sexual dysfunction
- Spasticity
- Tremor
- Uhthoff’s phenomenon
- Weakness
Other symptoms of MS include:
- Bipolar disorder
- Dysarthria
- Dysphagia
- Dry mouth
- Hormonal Influences for women
- Poor coordination
- Uncontrolled or involuntary laughter or crying
MS usually occurs during the most productive years of individuals. As such, one of the challenges people with MS face is under- and unemployment. In one estimate, up to 80% of Canadians suffering from this disease are likely to be unemployed.
MS Exercise Program
Fear of exacerbating symptoms is the primary reason for inactivity or decline in physical activity among MS patients. However, there is plenty of evidence from numerous studies showing the beneficial effects of fitness training – those specifically designed for patients on a case-to-case basis.
Regular physical activity benefits MS patients with:
- Improved cardiovascular fitness
- Enhanced strength, balance, and flexibility
- More normal bladder and bowel function
- Less fatigue and depression
- Enhanced mood and focus
- Better social interaction
Canadian Physical Activity Guidelines for Adults with Multiple Sclerosis
The Canadian Society for Exercise Physiology (CSEP), formerly called the Canadian Association of Sport Sciences, published their recommended fitness guidelines for adults (18 to 64 years old) with mild to moderate MS.
Aerobic Activity
- Performed twice a week
- Gradual increase of activity until reaching 30 minutes per session
- Exercises performed at moderate intensity
Strength Training Activity
- Performed twice a week, rest muscles for at least one day in between training sessions
- Gradually increase to two sets of 10-15 repetitions
- Adjust resistance to allow 10-15 repetitions
NCHPAD Prescribed Physical Activity and Exercise for a Person with MS
The National Center on Health, Physical Activity and Disability (NCHPAD) is a public health practice and resource center on health promotion for people with a disability.
Aerobic Activity
- Performed 3-4 days per week, 20-60 minutes each session
- Try to maintain a 12-14 rate of perceived exertion
Strength Training Activity
- Performed 2-3 times per week
- Do three sets of 8-12 repetitions, each session lasting 10-15 minutes
- Start an exercise at 70% of a maximum of 10 repetitions. Increase weight by 10% when the patient can perform 25 repetitions for two consecutive sessions
- Avoid training the same muscle groups on consecutive days
Flexibility Training
- Performed daily for 10-15 minutes
- Each stretching exercise held for 15-30 seconds, static stretches held for 5-15 seconds
- Stretching exercises is required before and after any cardiovascular or strength training sessions
Personal Trainer for MS Patients
Hiring a personal trainer who can help a person with MS is not an easy task. You want to find someone who holds a certification and has had experience – the more extensive, the better. One reason for that is the nature of the disease, in which some symptoms may change in a day. Moreover, there are other considerations such as physical condition and the specialized gym equipment.
Among the things that personal trainers specializing in MS do are:
- Plan a fitness training program for overall wellness, not to replace rehabilitation therapy.
- Adjusting the FIT (frequency, intensity, and time) to suit individual needs, thereby helping patients attain their goals.
- Understanding that MS patients tend to feel tired and hot quickly, they can plan flexible breaks.
- Patient and can repeat, if necessary, instructions in case of difficulty in cognition.
- Can recognize symptoms when they change and adjust the exercise program.
- Most importantly, reduce the risk of injury and act accordingly in case of an accident.
Addressing Hindrance to Doing Exercise Programs
An advantage of hiring fitness professionals trained in handling MS is that they can help patients overcome obstacles.
Specialized equipment. For training sessions in a gym, the standard equipment may not always be suitable. Some patients might have mobility issues, necessitating the use of a cane, walker, or wheelchair. Hence, the facility needs to modify some of the equipment and make it possible for the patient to perform an exercise routine.
Fatigue. Slowing nerve conduction in the central nervous system and demyelination is the cause of primary fatigue. On the other hand, poor sleep-wake cycle and quality of sleep, deconditioning, improper nutrition are the causes of secondary fatigue. Regardless of which, some MS patients may not be able to perform some exercise programs as well as others. Personal trainers familiar with symptoms of multiple sclerosis can guide these patients, controlling the pace to make the endeavour fun and let them reach their fitness goals.
Sensitivity to heat. Multiple sclerosis can cause body temperature to increase at a higher rate than normal. Highly-trained personal trainers are aware of that and can make sure to avoid complications by ensuring a cool environment and providing cold drinks.
Impact of limited energy. For multiple sclerosis patients, travelling to the gym and walking from one machine to the other can drain their energy. Personal trainers specializing in MS are aware of this and can, thus, consider these factors in creating exercise programs.
Having Fun Attaining Fitness Goals
Personal training pros bring more than what was already stated in previous sections on the table. For one, they can keep the motivation level up by making attainable goals. It prevents the frustration patients may feel if progress is too slow. In doing aerobic exercise or cardiovascular training, they can increase the intensity at a proper pace that is safe and yet remains doable. Most importantly, they can prevent accidents or worsening symptoms.
Gera is the Founder and Head Trainer of First Class Personal Training with over 20 years of professional experience, not only as a personal trainer but also as a nutrition and wellness counselor and a post rehabilitation specialist.