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Table 2

Physical Activity

General Guidelines for Prescribing Physical Activity and Exercise for a Person with MS	Activities of daily living Built-in Inconveniences Leisure Activities Hobbies
General Goals	Increase daily activity energy expenditure
Intensity/Frequency/ Duration	30 minutes of accumulated physical activity each day on most days
Special Considerations	Strategies for energy conservation may be necessary

Aerobic and Endurance Exercise

General Guidelines for Prescribing Physical Activity and Exercise for a Person with MS	Cycling Walking Water aerobics Chair exercise
General Goals	Increase cardiovascular function
Intensity/Frequency/Duration	60-75% HR peak or 50-65% VO2 peak; 3 sessions/week; one 30-min session or three 10-min sessions per day
Special Considerations	Air temperature should be kept cool; fans may be helpful

Strength Training/Resistance Training

General Guidelines for Prescribing Physical Activity and Exercise for a Person with MS	Elastic bands or free weights Weight machines Pulley weights
General Goals	Increase general muscle strength Equalize agonist/antagonist strength
Intensity/Frequency/Duration	Perform on non-endurance training days
Special Considerations	Therapeutic swimming pool water temperature is too warm With any upper extremity sensory deficit, free weights should not be used

Flexibility (stretching)

General Guidelines for Prescribing Physical Activity and Exercise for a Person with MS	Passive range of motion (ROM) Active ROM Yoga Tai Chi
General Goals	Increase joint range of motion Counteract effects of spasticity Improve balance
Intensity/Frequency/Duration	Perform daily for short periods, preferably more than once per day if fatigue occurs
Special Considerations	Exercises should be performed in a seated or lying position when possible

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