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LIVING WITH MS Exercise can mean longer, healthier lives

On the Mend
Joe DiVincenzo

There are hundreds of thousands of people living in the U.S. with multiple sclerosis, or MS. Just 15 years ago, a diagnosis of MS was associated with a progressive loss of function and a slow decline in activity. But that's not true anymore — and we have exercise to thank.

Multiple Sclerosis is a disease that affects the central and peripheral nervous system. Our nerves have a delicate case called "myelin," which aides in transmission of motor and sensory signals to and from the brain. In MS, the protective myelin corrodes and leaves the nerves exposed to damage and other harmful bodily chemicals. Symptoms of MS include motor weakness, pain, sensory changes and trouble seeing in certain lights.

While the cause of MS remains unknown, we know a considerable amount about the disease and how to best manage it.

There are four main types of Multiple Sclerosis. Eighty-five percent of all cases are diagnosed as relapsing-remitting. This describes a pattern where patients will have minimal symptoms for an extended period of time, and then experience a sudden setback. Most patients make a full recovery, or at most, lose about 5 percent of their previous level of function.

Despite an enormous research effort, there is still no cure for Multiple Sclerosis. Currently, our best interventions are aimed at prevention and resolution of flare-ups. MS flares are periods of time where the disease worsens and symptoms temporarily spike. The length and severity of a flare are dependent on several factors.

Alleviation of aggravating factors and proper medical management are first-line defenses as soon as you recognize that you're "in a flare."

Most patients with MS are on a prophylactic medication regimen, but preventative treatment alone is not strong enough to counteract the drop in function that results from a flare. Your doctor will start you on a heavy dose of intravenous steroids which dramatically reduce inflammation of the nervous system and return patients to their baseline level of function.

As a flare is the most detrimental and damaging part of MS, it can be implied that strategies focused on controlling and preventing them will promote the healthiest lifestyle possible.

Fortunately, physical therapy can offer several solutions to manage your symptoms and keep you functioning without using too much effort.

Getting in shape without direct supervision from a health care professional can be more dangerous than you'd expect. Patients with multiple sclerosis who exercise without guidance are at an astronomical risk for injuring muscle tissue and scarring nerves beyond repair.

Adequate strength ensures that common daily tasks do not over-tax already weakened muscles. Weight training is the single most important aspect of a patient's program because it provides the critical framework of flare prevention. Having good muscular strength will allow you to move a couch, lift a heavy pot of water or load flowers into the trunk of your car without exacting too much strain. A diverse weight lifting program keeps your muscles on par with activities of your daily life.

Long, intense bouts of exercise will raise a person's body temperature, and it has been shown that heat acts as a catalyst to damage nerves. This sort of exercise is contraindicated, as it will cause irreparable damage to the central and peripheral nervous system. Short bouts of exercise that do not cause profuse sweating or redden the cheeks are generally benign, but all patients are advised to sit down with a physical therapist and iron out a safe cardiovascular workout plan before deciding on an exercise regimen.

While it can be debilitating, patients with MS are living longer and healthier lives than ever — and that is largely due to proper exercise routines. If you've been diagnosed, or have a family member who has MS, encourage them to seek exercise counseling — it could be the best move you ever make.

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