People with MS can make a number of positive changes to their lifestyle to help manage symptoms and improve quality of life. Exercise is a safe strategy that provides benefits including improving physical fitness, physical function, fatigue, mood and quality of life for people with MS. The recently published evidence-based guide, Adapting Your Lifestyle: A Guide for People with MS, gives practical tips on exercise and other health behaviours that can improve MS.
There can often be confusion between exercise and physical activity. Physical activity is a general term for movement throughout the day, and can be planned or unplanned leisure, occupational, or household activities. Exercise is a form of physical activity that is often completed with the goal of improving your fitness, physical performance, or your health. Exercise types range from aerobic exercise (brisk walking, jogging, bicycling), strength exercise (lifting weights), stretching, or balance exercises. Physical activity and exercise have many benefits, including for mental health.
Studies from other countries show that on average people with MS are less active than people without MS. However, until recently we didn’t have specific information about Australians with MS. Using data from the Australian MS Longitudinal Study (AMSLS) we assessed physical activity and exercise participation in people with MS. The results, published in Disability and Rehabilitation, showed that just over half of the 1,216 participants reported moderate to high physical activity levels in the past week, while the other 47% reported low levels of physical activity.
The amount of physical activity differed according to the level of disability people reported. Of those participants who reported no or mild disability (e.g. they can walk unassisted), more than two thirds reported moderate to high physical activity levels, which is in line with the average among Australian adults. However, far fewer participants with moderate (47%) or severe (20%) levels of disability reported meeting moderate-high levels of physical activity.
The amount of time sitting per day was in line with reports from the general Australian population: seven hours per day. The results also showed that those participants who reported lower levels of physical activity and higher sitting duration were more likely to include men, people with progressive onset MS, and people with more severe symptoms of depression, fatigue, and cognitive impairment.
We also investigated participation in different forms of exercise. The most popular form of exercise was aerobic activity, with four out of five participants engaging in this (commonly around four hours per week). Less common were balance and strength exercises, with two out of five engaging in balance and flexibility activities (commonly around two hours a week), and less than one in five participants engaging in strength training (commonly just over one hour per week).
As indicated in MS Research Australia’s new evidence-based lifestyle guide, exercise guidelines recommend that people with mild to moderate MS perform a minimum of two sessions of aerobic exercise AND two sessions of strength exercise per week. From the study results, we found that at least four out of five of our participants reported not participating in any strength exercise at all. Many Australian adults without MS (90%) are also not engaging in strength exercise, so this result is not unexpected. However, for people with MS it is particularly important to maintain muscle strength and follow these recommendations.
We know that people with MS report barriers to exercise, including a lack of clear advice about the type and intensity of exercise which is appropriate for each individual, managing fatigue, and difficulties with access to equipment or professional assistance. Events such as the Australian bushfires and the ongoing pandemic have likely increased existing barriers to regular exercise for some people, and we are currently investigating this through the Crisis Resilience in People with MS study. Perhaps now more than ever, Australians with MS may need more assistance finding ways to maintain their physical activity participation.
If you want to take advantage of the benefits exercise can offer, we encourage you to obtain a referral from your GP to a physiotherapist, exercise physiologist or occupational therapist. These professionals can help you get started with an exercise regime, particularly if you are unsure where to start with strength exercises. They can also help you improve your current exercise regime so that it is safe, appropriate, and enjoyable for you.