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Ask the Experts: Multiple Sclerosis

Cameron, Michelle M.D., P.T.

doi: 10.1097/01.NNN.0000429071.11712.59
Departments: Your Questions Answered

Answers to your reader questions about multiple sclerosis and parkinsonism.

Michelle Cameron, M.D., P.T., is an assistant professor in the department of neurology at Oregon Health & Science University and a member of the American Academy of Neurology.


Q Is exercise beneficial and safe for people with MS? Can it slow disease progression?




A At one time, people with multiple sclerosis (MS) were advised to avoid exercise. But we now know that exercise can improve many of the symptoms of MS.

People with MS develop lesions in the brain, spinal cord, and optic nerves. Most scientists believe these lesions are caused by inflammation produced by the body's own immune system. The lesions and the inflammation interfere with nervous system function and can cause a wide range of symptoms, including weakness, imbalance, fatigue, depression, and cognitive problems. Currently, the most effective treatments to slow the progression of MS are disease-modifying medications. However, various types of exercise have been shown to help people with MS function and feel better.

For example, progressive strengthening exercises, such as weight lifting or other forms of resistance exercise (e.g. elastic bands), can strengthen muscles weakened by MS. Endurance and balance exercises help patients feel less fatigue and achieve better balance. Exercise has also been shown to reduce the stress and depression that often accompany the disease.

People with MS can exercise in many different ways. Exercising alone requires that the person is not at serious risk for falls or other injuries. Exercising in a group helps some people stay motivated. Many people benefit from individual instruction by a physical therapist, who can develop a personalized program that matches a patient's goals and abilities.

In animal models of MS, exercise has been found to protect against damage from the disease, for example by influencing levels of neurotrophins, which are proteins that promote the development, maintenance, and survival of neurons in the brain.

Before starting an exercise program, talk to your doctor. An individual's ideal exercise program should be driven by his or her needs and goals—and by what that person enjoys and therefore is likely to do on a regular basis.

© 2013 American Academy of Neurology