Many of my patients tell me that they don’t exercise because, “they don’t know what exercises to do.” This is a curious problem, on the one hand not exercising is a safe solution, after all, if you don’t know what the

proper exercise is then maybe you will be hurting yourself if you push yourself to exercise, especially if you have a chronic condition like Multiple Sclerosis (MS). On the other hand, if you don’t do anything at all, with or without MS, you are limiting your overall health.

Over the years I have had many discussions with patients about this topic and have come to realize that the answer is difficult in part because getting regular exercise is hard work, fatiguing, time consuming, etc, for anyone, and often much harder for someone with MS. Only 20.4% of adults in the United States actually met the federal physical activity guidelines in 2010. In fact, the CDC found that fewer than two in 10 Americans get the recommended levels of exercise, and more than a quarter of U.S. adults do not devote any time to physical activity. Federal guidelines call for 150 minutes of moderate to vigorous physical activity every week, including two days of full-body strengthening.

Those guidelines are for the average healthy person, how does someone with MS interpret them? How much exercise does a person with MS need? There is clear evidence that MS can affect endurance, cause pain and fatigue, effect walking stability, and make overall life tasks more difficult. In addition, there is rising evidence that exercise may have natural re-myelination capabilities. However, the heterogeneity of the disease and the multitude of symptoms that accompany it make it difficult to determine concrete guidelines for exercise. As a movement scientist who studies exercise and its affects on walking and balance for individuals with MS I have a vested interest in keeping up with the scientific evidence about this very topic. Based on the evidence that I am aware of most people with the relapsing form of MS should prioritize physical exercise along with disease modifying medications. Check back on Wednesday for more tips on exercising with MS.

*Dr. Zackowski is currently an Assistant Professor in the Department of Physical Medicine and Rehabilitation and Neurology at the Kennedy Krieger Institute/Johns Hopkins School of Medicine. She is certified as a Multiple Sclerosis (MS) Specialist and works as the sole Occupational Therapist at the Johns Hopkins MS Center. Dr. Zackowski’s research interests are to investigate the mechanisms that underlie sensorimotor impairments and disability resulting from damage to the central nervous system so as to improve disability. To this point her studies have focused on the motor control problems that occur as a result of neurodegenerative disease processes such as multiple sclerosis. Dr. Zackowski’s current studies investigate the extent that nerve fiber changes in the brain and spinal cord are associated with changes in walking and physical impairments such as strength and sensation, in the context of an exercise strengthening program.