Ok, we all know that we should be exercising. Besides all of the great stuff that exercise does for everyone (lowered cardiovascular risk, increased muscle mass, etc.), research on the effects of exercise in MS has shown that it:
Lowers risk for depression
Improves MS-related fatigue
Improves cognitive functioning
Notably, exercise has also been shown to increase overall daily activity level, functional capacity and balance in people with MS as well. Overall, this adds up to a measurable increase in quality of life. There is even limited evidence in animal models that exercise therapy may halt, slow or reverse disease progression of MS.
Exercise therapy, as it has been studied, is “an individualized prescribed exercise or plan designed to restore health and prevent further disease or disability.” Typically, this is prescribed by a doctor through a physical therapist or other supervised situation. There are specific guidelines, based on scientific data, for programs combining resistance and endurance testing.
While that is great and all, raise your hand if you are currently participating in an exercise therapy program. See what I mean? Studies show that fewer than 20% of people in the general US population get the recommended 150 minutes of moderate-intensity exercise per week. In people with MS, this number is definitely lower, as research shows that activity in people with MS starts off low and declines over time.
So, why don’t we exercise? As a person with MS, that is a pretty simple question to answer: Even though I know it will make me feel better, many times I feel so horrible or so fatigued that the thought of 30 minutes of sustained exercise would just make me laugh. Or cry.
However, there may be an answer, according to Robert W. Motl in his presentation at ECTRIMS 2013, entitled “Physical activity in MS: Theory, determinants and behavioral interventions.”
Dr. Motl reminded the audience that it is not just people with MS who don’t stick to exercise programs. Over 50% of adults drop out of any formal exercise program after 3 months and after 6 months 75% have stopped exercising.
He has some ideas on how to prevent this exercise attrition, however. Rather than pushing an exercise therapy program, we should strive to incorporate more physical activity into our daily lives. Dr. Motl calls this “lifestyle activity,” and points out that intermittent exercise has been shown to have the same effect as “continuous bouts” of exercise. In other words, accumulating 30 minutes a day of moderate exertion doing normal things (walking to our car, gardening, pushing a vacuum cleaner) can be as effective as a 30-minute exercise session.
In addition to this new approach to getting our recommended daily allowance of exercise, Dr. Motl has been researching the effect of social cognitive theory, which relies on perceived self-efficacy. Simply put, a person will be much more likely to do something if they believe that they CAN do it. Putting this theory to the test, Dr. Motl’s group tried it out on people with MS. After three months, the people who participated in the self-efficacy component exercised more, exerted themselves more and reported feeling better than those in the group who did not receive the self-efficacy message.
I’m a huge fan of this new paradigm of incorporating exercise into daily life. After seeing the title of an article, “Is Sitting the New Smoking?” in a popular magazine, I bought a pedometer and now force myself to get at least 10,000 steps a day. Since a part of self-efficacy involves “modeling” or seeing others do the same thing, I monitor an online group of people who log their steps daily. In this way, I have made exercise a habit. I can tell you, I feel much better than I did than when I would visit the gym for 3 days straight and then take a 6-month break.
P.S. For those of you who may have limited mobility, you can still get the benefits from incorporating more physical activity into your day by exerting yourself to the extent possible to do daily activities.
Adaptive Tai Chi