MS Activity: How to Break the Magic Circle of Fatigue?

Exercise has a positive effect on coping with MS. What exercises are best for patients and when should training be stopped immediately? Dr. Anna Sejin, a neurological rehabilitation specialist, explains how to do it right

A mysterious and cunning disease. Doctor looks at scan (Photo: shutterstock)

Doctor looks at MRI (Photo: ShutterStock)

Multiple sclerosis is a mysterious and cunning disease. Today, doctors do not really have a way of predicting how it will manifest in each patient and what their effect will be on the body in the long run. This can lead to great frustration, but it is important to remember that there are aspects of coping with the disease that can be controlled to improve the quality of life.

One of the most powerful tools in this arsenal is exercise. A number of studies from recent years have determined that regular exercise can at least improve the quality of life alongside the disease and in many cases improve body and mental health in a variety of aspects. For example, today there is plenty of evidence to show that exercise in MS patients can contribute to heart health, reduce anxiety and improve mood.

The new treatments have dramatically improved the management of multiple sclerosis

Beat the lingering fatigue

Dr. Anna Sezin is director of the rehabilitation department at Ichilov Hospital in Tel Aviv and a specialist in physical medicine and rehabilitation, with emphasis on neurological rehabilitation. As part of her role, she accompanies many patients, at different levels of functioning, who face different and unique difficulties. One of the most significant problems in the vast majority of its patients is fatigue.

"MS is a disease that is very common in young people. These are years when people run around day and night between work, recreation and study - and don't need too much rest. For MS patients the situation is the opposite - they get tired very fast, can't work several hours in succession and feel different So much from their friends and the rest of their peers, who don't always understand this coping. "

Exercise is a most effective way to reduce chronic fatigue among patients (Photo: shutterstock)

Man in physical therapy (Photo: ShutterStock)

A 2017 study found that exercise is a very effective way to reduce chronic fatigue among MS patients, maintain energy levels, and even reduce the risk of the disease disrupting various functional abilities. "People do not understand that this disease impairs some of the most important functions for self-management. Some patients find it difficult to dress, bathe and do home work. In all, exercise can help or ease," she adds.

What activities are recommended for MS patients?

Yoga and Pilates: One of the most common symptoms of illness is muscle tone. One way to overcome this is to make sure you do stretching exercises. "Yoga is a great way to stretch your muscles, strengthen them, and reduce their stiffness," she stressed. In addition, yoga also has a meditative and relaxing effect that has been shown in studies as a way to reduce mental stress and anxiety that characterize life with chronic illnesses.

Endurance training: Even when we go out for a walk, bike or swim, we greatly improve health in a way that affects, among other things, heart health and the respiratory system. It's worth thinking about how you incorporate more walking into your daily routine - even if you don't have the time for longer, more meaningful exercise.

Hydrotherapy (water movement exercises): In water, gravity works differently and so you can practice proper walking without the danger of falling to people whose walking ability is impaired by the disease. The exercise also contributes to muscle strengthening and reducing muscle tone. However, Sejin emphasizes that such training will not suit everyone. "In most treatment pools, the water temperature is around 37 degrees. For some patients, sclerosis impairs tolerance to heat and cold and in that case, staying in the water can be unpleasant at all. Treatment can also be very tiring so it is important to take a rest for at least an hour."

Strength Training: Of course, not everyone living with MS can do strength training - but when possible, it can be a great way to strengthen muscles and prevent their degeneration. The training can be done with rubber bands or weights and it is highly recommended that they be supervised by a professional trainer.

Listen to the body and not overdo it

When exercising, most people will gradually raise the level of difficulty, continue despite the pain and repeatedly break their own peaks. For example, many weightlifters will stop repetition in each "set" only when the muscles can no longer withstand the load. In contrast, Sejin urges people with multiple sclerosis to remember that their aspiration should be the opposite.

Exercise in proportion. Woman rolling a yoga mat (Photo: shutterstock)

Woman rolling a yoga mat (Photo: ShutterStock)

"MS is a disease that requires us to exercise in proportion," she emphasizes. "It's important not to do anything against the body and not continue if it hurts or if the body signals that it is not at load. But it can create unpleasant problems in the long run. "

And what if there is simply no motivation to exercise?

Exercise inactivation is a common problem that is common to almost all of us, but among MS patients, the situation seems to be far more complex. On the one hand, doctors explain that exercise will strengthen the body and help overcome fatigue. On the other hand - fatigue is exactly why it is so difficult to produce a workout routine.

This situation creates a fairly ironic "vicious circle" that seems difficult to get out of, but there are definitely ways to do it. "It is important for anyone with MS to know that they have an address for assistance," explains Dr. Sejin. "The hospital rehabilitation centers operate on a variety of levels to provide an overall envelope for dealing with the disease in order to improve functioning alongside the disease." Psychology, social services to realize all patients' rights, training in exercise and exercise, support groups and more.

"One of the best ways to overcome a lack of motivation is to utilize the strength of the team. If you come to the gym and see everyone exercising - you will not allow yourself to do anything. To receive a boost, reinforcement and motivation that will give them strength to improve life alongside the disease, "she says.

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