Multiple Sclerosis (MS) is a demylenating disease affecting the central
nervous system (CNS). Loss of fatty tissue, or myelin, surrounds the
nerves and adversely affects smooth and rapid conduction along CNS
pathways. MS symptoms can range from minimal to severe. Following are
some symptoms that could affect an MS client's ability to exercise:
* Impaired balance
* Uncoordinated movements
* Easily fatigued
* A feeling of numbness
* Muscle weakness
* Possible muscle paralysis
* Tremor and shaking
* Cardiovascular problems
Exercise cannot cure MS, but it can improve the short term physical
fitness performances of strength, endurance and aerobic fitness. When
training someone with MS you mave to take the following precautions:
* Remember that fatigue can reduce exercise tolerance
* Poor balance may influence the type of exercise chosen
* Sensory loss may eliminate upright activities such as walking or running
* Spastic muscles may require you to strap the clients feet down
* Recumbant cycling is a good exercise as it helps control balance
* Incontinence is common so give the client ample opportunities to use the restroom
* Paralysis is much more common in the lower extremeties
* Drugs for MS can create flu-like side effects increasing fatigue
* Some individuals have foot drop which reduces exercise capacity
*Controlling resistance in the arms and legs can reduce fatigue
Exercise precription for individuals with MS should concentrate on
maintenance. When possible, try to make improvements in flexibilty,
cardiorespiratory fitness and muscular strength and endurance. Fatigue
is the most cited complaint, so anything you can do to make movements
more efficient and less energy consuming will lead to greater gains.
The condition of the disease itself can vary from day to day so
trainers must have several lesson plans ready for each exercise session.
MS clients may also have psychological and cognitive problems. Memory
loss is common and may require written directions as well as verbal
communication. Those with MS may also require more mental processing
time to grasp instructions. Trainers should be competent in more than
one way of communicating.
Because MS symptoms can deteriorate
at a slower or faster rate, each individual's manner of fitness
progression will vary. Trainers need to be aware of daily variations in
medication side effects, rate of fatigue, and other changes in MS
symptoms. The trainer should be knowledgabe in lifting, carrying and
general assistance techniques for people with disabilities.
Some person's with MS have an absent or slowed sweating response. In
order to avoid overheating, exercise rooms should be kept at a neutral
or cool temperature. Fans should be provided and the clients encouraged
to drink often.
Lack of standard research in this area and the
variability of physical parameters in MS patients makes it nearly
impossible to set easy to follow exercise protocols. It is important to
follow The American College of Sports Medicine's guidelines for testing
clients with MS and to work closely with their neurologist. Less severe
MS symptoms will usually show greater improvement from exercising. As
the symptoms get worse, the increase in physical benefits will slow
with more time needed for improvements. |
