Important Considerations When Exercising
People with multiple sclerosis should consider and watch out for the following when exercising and when planning an exercise program or routine:
- Cardiovascular Dysautonomia: irregular function of the autonomic nervous system (ANS) leads to a blunted heart rate and decreased blood pressure in response to exercise. If this condition is present, heart rate and blood pressure must be monitored throughout the exercise program, and intensity might need to be decreased.
- Heat Sensitivity: can include fatigue, loss of balance and visual changes. Create a cool environment with fans, air temperature between 72Â° and 76Â°F, pool temperature between 80Â° and 85Â°F, and if exercising outdoors, exercise during early morning or evening hours. Wear clothing that breathes (i.e., cotton), and use cooling aids as needed (i.e., cool vests, ice packs, cool baths at 84Â°F or less, etc.). To counter dehydration, experiment with using sports drinks instead of water, depending on problems with incontinence.
- Incontinence: loss of control of bowel/bladder. Void bladder before exercise and monitor urinary cycle.
- Spasticity/Tremors: choose supportive exercise modalities, such as upright or recumbent bicycle instead of the treadmill, and use equipment, such as toe clips and heel straps for foot stability. Avoid water temperatures below 80°F and placing toes in a pointed position. When strength training, focus on areas of muscle imbalance, engage in gentle rhythmical/active flexibility exercises before exercise and in static flexibility movements after exercise that focus on increasing mobility and lengthening of tight areas (pelvis, chest, calf, and hip flexors).
- Balance and Coordination: choose exercises providing maximum support (i.e., swimming, recumbent bicycle), and check with a physical health professional (i.e., clinical exercise specialist, kinesiologist, exercise physiologist, or other fitness/health professional trained in exercise program design for individuals living with neurological conditions) to design a physical activity program that incorporates balance and coordination training.
- Medication: Be aware of side effects of medication you are taking and how this will affect your exercise program. Medication can affect energy level, muscle coordination and muscle strength.
- Fatigue: get to know your body well and be able to decipher between general muscle fatigue and other forms of fatigue (depression, cardiovascular, etc.). It may be wise to exercise in the morning before general fatigue sets in later in the afternoon.
- Additional tips from the National Muscular Sclerosis Society can be viewed here: https://www.youtube.com/watch?v=UB5kDzyiqpo