Benefits of exercising safely with multiple sclerosis


Benefits of exercising safely with multiple sclerosis

Over 25,000 Australians are living with Multiple sclerosis (MS), an immune-mediated disease that attacks the central nervous system. Physiotherapy, when part of a multidisciplinary treatment program, has been shown to improve physical health and enhance quality of life for people with MS.[1]

Expert physiotherapy advice about exercising safely early after diagnosis can maximise potential for independence and reduce the impact that the disease has on health and quality of life factors.

People with MS experience a wide range of symptoms, such as:

  • changes in memory, concentration, or reasoning
  • altered sensation, such as tingling, numbness or pins and needles sensitivity to heat/cold
  • fatigue
  • visual disturbance, such as blurred or double vision
  • paralysis
  • ataxia
  • incontinence

The severity and symptomology of MS is highly variable, with inflammation and neurodegeneration being key processes that lead to the damage of nervous system structures. Over time, this damage to white and grey matter tissue has been associated with the loss of body functions.

Physiotherapists provide specific rehabilitation programs, exercise plans and facilitate self management of MS symptoms.

Fatigue is reported in 70–80% of patients and is considered one of the most prevalent and disabling symptoms in all stages of the illness.

There are two kinds of MS-related fatigue: primary fatigue, associated with disease process and secondary fatigue, associated with MS complications, such as sleep disorders, reduced activity, and depression.[2]

Some studies described improvements in fatigue following aerobic exercise, resistance exercise, yoga, or a combination of both.[3]

Exercise is an essential component in the management of multiple sclerosis

Cardiorespiratory exercise training in MS isn’t just associated with increased postural stability, balance, VO2 Max, respiratory function, and reduction of fatigue.[4]

Physiotherapist led exercise has also been shown to lead to significant and important improvements in different areas of cardiorespiratory fitness (Aerobic fitness), muscle strength, flexibility, stability, tiredness, cognition, quality of life and respiratory function.

Data from these studies has also shown positive effects of aerobic fitness on brain grey matter volume and white matter integrity as well as on the influence of physical activity on resting-state functional connectivity of the hippocampus and cortex in people with MS.[5]

Hydrotherapy for multiple sclerosis has shown many benefits

Because of the varying physical symptoms of MS, the pain relieving effects of hydrotherapy during aerobic activity are welcomed by many. [6]

Thirty-two women with MS completed an 8-week aquatic exercise study measuring functional capacity, balance, and perceptions of fatigue. All outcome measures improved in the hydrotherapy group.[7]

Talk to your Lane Cove Physio if you would like to know more about exercise recommendations for people with MS. Exercise should be considered as a safe and effective means of rehabilitation in MS patients with evidence showing that a supervised and individualised exercise program may improve fitness, functional capacity and quality of life as well as modifiable impairments.

The COVID-19 pandemic shouldn’t derail your rehabilitation and physiotherapy goals. To book an in-person or telehealth physiotherapy appointment, contact Lane Cove Physio on (02) 9428 5772 or at

[1] McCullagh, R., Fitzgerald, A. P., Murphy, R. P. & Cooke, G. Long-term benefits of exercising on quality of life and fatigue in multiple sclerosis patients with mild disability: a pilot study. Clin. Rehabil. 22, 206–214 (2008).

[2] Chen, M.H.; Wylie, G.R.; Sandroff, B.M.; Dacosta-Aguayo, R.; DeLuca, J.; Genova, H.M. Neural mechanisms underlying state mental fatigue in multiple sclerosis: A pilot study. J. Neurol. 2020, 267, 2372–2382.

[3] Oken, B. S. et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology 62, 2058–2064 (2004).

[4] Latimer-Cheung AE, Pilutti LA, Hicks AL, Martin Ginis KA, Fenuta AM, MacKibbon KA, et al. Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. Arch Phys Med Rehabil. 2013;94(9):1800–28. e3

[5] Prakash, R. S., Snook, E. M., Motl, R. W. & Kramer, A. F. Aerobic fitness is associated with gray matter volume and white matter integrity in multiple sclerosis. Brain Res. 1341, 41–51 (2010).

[6] Castro-Sánchez AM, Matarán-Peñarrocha GA, Lara-Palomo I, Saavedra-Hernández M, Arroyo-Morales M, Moreno-Lorenzo C. Hydrotherapy for the treatment of pain in people with multiple sclerosis: a randomized controlled trial. Evidence-based complementary and alternative medicine. 2012

[7] Randomized Controlled Trial to Examine the Impact of Aquatic Exercise Training on Functional Capacity, Balance, and Perceptions of Fatigue in Female Patients With Multiple Sclerosis

Kargarfard M., Shariat A., Ingle L., Cleland J.A., Kargarfard M. (2018) Archives of Physical Medicine and Rehabilitation, 99 (2) , pp. 234-241.