Can we afford to continue to ignore the positive effect exercise has on MS? #ClinicSpeak #MSBlog #MSResearch
"The meta-analysis below shows that exercise improves walking speed and endurance in MSers. This is another piece of evidence that supports exercise as such an important part of the management of MS. In addition to physical performance exercise also boosts cognitive outcomes and boosts cognitive reserve. I can't think of any reason why MSers should not exercise, even MSers with disability. There is an exercise programme for everyone."
"Yesterday, thanks to you I won a debate making the case for pelvic floor exercises in all MSers. My case was based on the argument that pelvic floor exercises are simply part of a general exercise programme and supported by evidence that it improves bladder function and possibly sexual dysfunction. Why wouldn't you do pelvic floor exercises? As with all lifestyle interventions is how do you get people to do exercise and adhere to a long-term exercise programme? All ideas and suggestions welcome."
"If you have not sure how to start an exercise programme please ask your MS team to refer you to the physiotherapists."
Epub: Pearson et al. Exercise as a therapy for improvement of walking ability in adults with multiple sclerosis: A meta-analysis. Arch Phys Med Rehabil. 2015 Feb 21.
OBJECTIVE: To quantify improvements in walking performance commonly observed in patients with Multiple Sclerosis (pwMS). A systematic literature search and meta-analysis was conducted quantifying the expected benefits of exercise on walking ability in pwMS.
DATA SOURCES: Potential studies were identified by systematic search using PubMed (1966 to 31st March, 2014), EMBASE (1974 to 31st March, 2014), CINAHL (1998 to 31st March, 2014), SPORTSDiscus (1991-31st March, 2014) and the Cochrane Central Register of Controlled Trials (1966 to 31st March, 2014). The search used key concepts of "Multiple Sclerosis" AND "exercise".
STUDY SELECTION: Randomised controlled trials of exercise training in adult patients with MS.
DATA EXTRACTION: Data on patient and study characteristics; walking ability; 10metre walk test (10mWT); Timed 25-foot walk test (T25FW); 2 minute walk test (2MWT); 6 minute walk test (6MWT); Timed up and go (TUG) were extracted and archived.
DATA SYNTHESIS: Data from 13 studies were included. Exercise produced significant improvements in walking speed, measured by 10mWT, mean difference (MD) reduction in walking time of -1.76 seconds (95%CI -2.47 to -1.06, p<0.001), but no change in the T25FW MD = -0.59s (95%CI -2.55 to 1.36, p=0.55). Exercise produced significant improvements in walking endurance as measured by 6MWT and 2MWT, with increased walking distance of MD=36.46 metres (95%CI 15.14 to 57.79, P<0.001) and MD=12.51 metres (95%CI 4.79 to 20.23, p=0.001), respectively. No improvement was found for TUG MD = -1.05s (95% CI -2.19 to 0.09, p=0.07).
CONCLUSIONS: Our meta-analysis suggests exercise improves walking speed and endurance in pwMS.