Skip to main content
Top
Published in: Sports Medicine 15/2004

01-12-2004 | Review Article

Exercise and Multiple Sclerosis

Authors: Lesley J. White, Rudolph H. Dressendorfer

Published in: Sports Medicine | Issue 15/2004

Login to get access

Abstract

The pathophysiology of multiple sclerosis (MS) is characterised by fatigue, motor weakness, spasticity, poor balance, heat sensitivity and mental depression. Also, MS symptoms may lead to physical inactivity associated with the development of secondary diseases. Persons with MS are thus challenged by their disability when attempting to pursue an active lifestyle compatible with health-related fitness. Although exercise prescription is gaining favour as a therapeutic strategy to minimise the loss of functional capacity in chronic diseases, it remains under-utilised as an intervention strategy in the MS population. However, a growing number of studies indicate that exercise in patients with mild-to-moderate MS provides similar fitness and psychological benefits as it does in healthy controls.
We reviewed numerous studies describing the responses of selected MS patients to acute and chronic exercise compared with healthy controls. All training studies reported positive outcomes that outweighed potential adverse effects of the exercise intervention. Based on our review, this article highlights the role of exercise prescription in the multidisciplinary approach to MS disease management for improving and maintaining functional capacity. Despite the often unpredictable clinical course of MS, exercise programmes designed to increase cardiorespiratory fitness, muscle strength and mobility provide benefits that enhance lifestyle activity and quality of life while reducing risk of secondary disorders. Recommendations for the evaluation of cardiorespiratory fitness, muscle performance and flexibility are presented as well as basic guidelines for individualised exercise testing and training in MS. Special considerations for exercise, including medical management concerns, programme modifications and supervision, in the MS population are discussed.
Literature
1.
go back to reference Noseworthy JH, Lucchinetti C, Rodriguez M, et al. Multiple sclerosis. N Engl J Med 2000; 343 (13): 938–52PubMed Noseworthy JH, Lucchinetti C, Rodriguez M, et al. Multiple sclerosis. N Engl J Med 2000; 343 (13): 938–52PubMed
2.
go back to reference Frohman EM. Multiple sclerosis. Med Clin North Am 2003; 87 (4): 867–97, viii-xPubMed Frohman EM. Multiple sclerosis. Med Clin North Am 2003; 87 (4): 867–97, viii-xPubMed
3.
go back to reference Freeman JA. Improving mobility and functional independence in persons with multiple sclerosis. J Neurol 2001; 248 (4): 255–9PubMed Freeman JA. Improving mobility and functional independence in persons with multiple sclerosis. J Neurol 2001; 248 (4): 255–9PubMed
4.
go back to reference Slawta JN, McCubbin JA, Wilcox AR, et al. Coronary heart disease risk between active and inactive women with multiple sclerosis. Med Sci Sports Exerc 2002; 34 (6): 905–12PubMed Slawta JN, McCubbin JA, Wilcox AR, et al. Coronary heart disease risk between active and inactive women with multiple sclerosis. Med Sci Sports Exerc 2002; 34 (6): 905–12PubMed
5.
go back to reference Lambert CP, Lee Archer R, Evans WJ. Body composition in ambulatory women with multiple sclerosis. Arch Phys Med Rehabil 2002; 83 (11): 1559–61PubMed Lambert CP, Lee Archer R, Evans WJ. Body composition in ambulatory women with multiple sclerosis. Arch Phys Med Rehabil 2002; 83 (11): 1559–61PubMed
6.
go back to reference White L, Dressendorfer R. Fitness testing in multiple sclerosis: a case report [abstract]. Med Sci Sports Exerc 2003; 35 (5): S314 White L, Dressendorfer R. Fitness testing in multiple sclerosis: a case report [abstract]. Med Sci Sports Exerc 2003; 35 (5): S314
7.
go back to reference Petajan JH, Gappmaier E, White AT, et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 1996; 39 (4): 432–41PubMed Petajan JH, Gappmaier E, White AT, et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 1996; 39 (4): 432–41PubMed
8.
go back to reference Johnson BD, Aaron EA, Babcock MA, et al. Respiratory muscle fatigue during exercise: implications for performance. Med Sci Sports Exerc 1996; 28 (9): 1129–37PubMed Johnson BD, Aaron EA, Babcock MA, et al. Respiratory muscle fatigue during exercise: implications for performance. Med Sci Sports Exerc 1996; 28 (9): 1129–37PubMed
9.
go back to reference Freal JE, Kraft GH, Coryell JK. Symptomatic fatigue in multiple sclerosis. Arch Phys Med Rehabil 1984; 65 (3): 135–8PubMed Freal JE, Kraft GH, Coryell JK. Symptomatic fatigue in multiple sclerosis. Arch Phys Med Rehabil 1984; 65 (3): 135–8PubMed
10.
go back to reference Ponichtera-Mulcare J, Mathews T, Barrett PJ, et al. Changes in aerobic fitness of patients with multiple sclerosis after a 6-month training program. Sports Med Train Rehabil 1997; 7: 265–72 Ponichtera-Mulcare J, Mathews T, Barrett PJ, et al. Changes in aerobic fitness of patients with multiple sclerosis after a 6-month training program. Sports Med Train Rehabil 1997; 7: 265–72
11.
go back to reference Rodgers MM, Mulcare JA, King DL, et al. Gait characteristics of individuals with multiple sclerosis before and after a 6-month aerobic training program. J Rehabil Res Dev 1999; 36 (3): 183–8PubMed Rodgers MM, Mulcare JA, King DL, et al. Gait characteristics of individuals with multiple sclerosis before and after a 6-month aerobic training program. J Rehabil Res Dev 1999; 36 (3): 183–8PubMed
12.
go back to reference Mostert S, Kesselring J. Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Mult Scler 2002; 8 (2): 161–8PubMed Mostert S, Kesselring J. Effects of a short-term exercise training program on aerobic fitness, fatigue, health perception and activity level of subjects with multiple sclerosis. Mult Scler 2002; 8 (2): 161–8PubMed
13.
go back to reference Gehlsen GM, Grigsby SA, Winant DM. Effects of an aquatic fitness program on the muscular strength and endurance of patients with multiple sclerosis. Phys Ther 1984; 64 (5): 653–7PubMed Gehlsen GM, Grigsby SA, Winant DM. Effects of an aquatic fitness program on the muscular strength and endurance of patients with multiple sclerosis. Phys Ther 1984; 64 (5): 653–7PubMed
14.
go back to reference Kraft GH, Alquist AD, Lateur BJ. Effects of resistive exercise on function in multiple sclerosis (MS) [abstract]. Arch Phys Med Rehabil 1996; 77: 984 Kraft GH, Alquist AD, Lateur BJ. Effects of resistive exercise on function in multiple sclerosis (MS) [abstract]. Arch Phys Med Rehabil 1996; 77: 984
15.
go back to reference Kraft GH, Alquist AD, Lateur BJ. Effect of resistive exercise on strength in multiple sclerosis [abstract]. Arch Phys Med Rehabil 1996; 77: 984 Kraft GH, Alquist AD, Lateur BJ. Effect of resistive exercise on strength in multiple sclerosis [abstract]. Arch Phys Med Rehabil 1996; 77: 984
16.
go back to reference Mulcare JA. Multiple sclerosis. In: ACSM’s exercise management for person’s with chronic diseases and disabilities. Champaign (IL): Human Kinetics, 2003 Mulcare JA. Multiple sclerosis. In: ACSM’s exercise management for person’s with chronic diseases and disabilities. Champaign (IL): Human Kinetics, 2003
17.
go back to reference Pelfrey CM, Cotleur AC, Lee JC, et al. Sex differences in cytokine responses to myelin peptides in multiple sclerosis. J Neuroimmunol 2002; 130 (1–2): 211–23PubMed Pelfrey CM, Cotleur AC, Lee JC, et al. Sex differences in cytokine responses to myelin peptides in multiple sclerosis. J Neuroimmunol 2002; 130 (1–2): 211–23PubMed
18.
go back to reference Owens T. The enigma of multiple sclerosis: inflammation and neurodegeneration cause heterogeneous dysfunction and damage. Curr Opin Neurol 2003; 16 (3): 259–65PubMed Owens T. The enigma of multiple sclerosis: inflammation and neurodegeneration cause heterogeneous dysfunction and damage. Curr Opin Neurol 2003; 16 (3): 259–65PubMed
19.
go back to reference Ozawa K. Immunologic therapy for secondary and primary progressive multiple sclerosis [in Japanese]. Nippon Rinsho 2003; 61 (8): 1449–54PubMed Ozawa K. Immunologic therapy for secondary and primary progressive multiple sclerosis [in Japanese]. Nippon Rinsho 2003; 61 (8): 1449–54PubMed
20.
go back to reference Iriarte J, de Castro P. Correlation between symptom fatigue and muscular fatigue in multiple sclerosis. Eur J Neurol 1998; 5 (6): 579–85PubMed Iriarte J, de Castro P. Correlation between symptom fatigue and muscular fatigue in multiple sclerosis. Eur J Neurol 1998; 5 (6): 579–85PubMed
21.
go back to reference Latash M, Kalugina E, Nicholas J, et al. Myogenic and central neurogenic factors in fatigue in multiple sclerosis. Mult Scler 1996; 1 (4): 236–41PubMed Latash M, Kalugina E, Nicholas J, et al. Myogenic and central neurogenic factors in fatigue in multiple sclerosis. Mult Scler 1996; 1 (4): 236–41PubMed
22.
go back to reference Sharma KR, Kent-Braun J, Mynhier MA, et al. Evidence of an abnormal intramuscular component of fatigue in multiple sclerosis. Muscle Nerve 1995; 18 (12): 1403–11PubMed Sharma KR, Kent-Braun J, Mynhier MA, et al. Evidence of an abnormal intramuscular component of fatigue in multiple sclerosis. Muscle Nerve 1995; 18 (12): 1403–11PubMed
23.
go back to reference Petajan JH, White AT. Motor-evoked potentials in response to fatiguing grip exercise in multiple sclerosis patients. Clin Neurophysiol 2000; 111 (12): 2188–95PubMed Petajan JH, White AT. Motor-evoked potentials in response to fatiguing grip exercise in multiple sclerosis patients. Clin Neurophysiol 2000; 111 (12): 2188–95PubMed
24.
go back to reference Sheean GL, Murray NM, Rothwell JC, et al. An electrophysiological study of the mechanism of fatigue in multiple sclerosis. Brain 1997; 120 (Pt 2): 299–315PubMed Sheean GL, Murray NM, Rothwell JC, et al. An electrophysiological study of the mechanism of fatigue in multiple sclerosis. Brain 1997; 120 (Pt 2): 299–315PubMed
25.
go back to reference Foglio K, Clini E, Facchetti D, et al. Respiratory muscle function and exercise capacity in multiple sclerosis. Eur Respir J 1994; 7 (1): 23–8PubMed Foglio K, Clini E, Facchetti D, et al. Respiratory muscle function and exercise capacity in multiple sclerosis. Eur Respir J 1994; 7 (1): 23–8PubMed
26.
go back to reference Pepin EB, Hicks RW, Spencer MK, et al. Pressor response to isometric exercise in patients with multiple sclerosis. Med Sci Sports Exerc 1996; 28 (6): 656–60PubMed Pepin EB, Hicks RW, Spencer MK, et al. Pressor response to isometric exercise in patients with multiple sclerosis. Med Sci Sports Exerc 1996; 28 (6): 656–60PubMed
27.
go back to reference Senaratne MP, Carroll D, Warren KG, et al. Evidence for cardiovascular autonomic nerve dysfunction in multiple sclerosis. J Neurol Neurosurg Psychiatry 1984; 47 (9): 947–52PubMed Senaratne MP, Carroll D, Warren KG, et al. Evidence for cardiovascular autonomic nerve dysfunction in multiple sclerosis. J Neurol Neurosurg Psychiatry 1984; 47 (9): 947–52PubMed
28.
go back to reference Tantucci C, Massucci M, Piperno R, et al. Control of breathing and respiratory muscle strength in patients with multiple sclerosis. Chest 1994; 105 (4): 1163–70PubMed Tantucci C, Massucci M, Piperno R, et al. Control of breathing and respiratory muscle strength in patients with multiple sclerosis. Chest 1994; 105 (4): 1163–70PubMed
29.
go back to reference Mevellec E, Lamotte D, Cantalloube S, et al. Relationship between gait speed and strength parameters in multiple sclerosis [in French]. Ann Readapt Med Phys 2003; 46 (2): 85–90PubMed Mevellec E, Lamotte D, Cantalloube S, et al. Relationship between gait speed and strength parameters in multiple sclerosis [in French]. Ann Readapt Med Phys 2003; 46 (2): 85–90PubMed
30.
go back to reference Gold SM, Schulz KH, Hartmann S, et al. Basal serum levels and reactivity of nerve growth factor and brain-derived neurotrophic factor to standardized acute exercise in multiple sclerosis and controls. J Neuroimmunol 2003; 138 (1–2): 99–105PubMed Gold SM, Schulz KH, Hartmann S, et al. Basal serum levels and reactivity of nerve growth factor and brain-derived neurotrophic factor to standardized acute exercise in multiple sclerosis and controls. J Neuroimmunol 2003; 138 (1–2): 99–105PubMed
31.
go back to reference Nielsen JF, Norgaard P. Increased post-exercise facilitation of motor evoked potentials in multiple sclerosis. Clin Neurophysiol 2002; 113 (8): 1295–300PubMed Nielsen JF, Norgaard P. Increased post-exercise facilitation of motor evoked potentials in multiple sclerosis. Clin Neurophysiol 2002; 113 (8): 1295–300PubMed
32.
go back to reference de Ruiter CJ, Jongen PJ, van der Woude LH, et al. Contractile speed and fatigue of adductor pollicis muscle in multiple sclerosis. Muscle Nerve 2001; 24 (9): 1173–80PubMed de Ruiter CJ, Jongen PJ, van der Woude LH, et al. Contractile speed and fatigue of adductor pollicis muscle in multiple sclerosis. Muscle Nerve 2001; 24 (9): 1173–80PubMed
33.
go back to reference Lambert CP, Archer RL, Evans WJ. Muscle strength and fatigue during isokinetic exercise in individuals with multiple sclerosis. Med Sci Sports Exerc 2001; 33 (10): 1613–9PubMed Lambert CP, Archer RL, Evans WJ. Muscle strength and fatigue during isokinetic exercise in individuals with multiple sclerosis. Med Sci Sports Exerc 2001; 33 (10): 1613–9PubMed
34.
go back to reference White AT, Wilson TE, Davis SL, et al. Effect of precooling on physical performance in multiple sclerosis. Mult Scler 2000; 6 (3): 176–80PubMed White AT, Wilson TE, Davis SL, et al. Effect of precooling on physical performance in multiple sclerosis. Mult Scler 2000; 6 (3): 176–80PubMed
35.
go back to reference de Haan A, de Ruiter CJ, van Der Woude LH, et al. Contractile properties and fatigue of quadriceps muscles in multiple sclerosis. Muscle Nerve 2000; 23 (10): 1534–41PubMed de Haan A, de Ruiter CJ, van Der Woude LH, et al. Contractile properties and fatigue of quadriceps muscles in multiple sclerosis. Muscle Nerve 2000; 23 (10): 1534–41PubMed
36.
go back to reference Ng AV, Dao HT, Miller RG, et al. Blunted pressor and intramuscular metabolic responses to voluntary isometric exercise in multiple sclerosis. J Appl Physiol 2000; 88 (3): 871–80PubMed Ng AV, Dao HT, Miller RG, et al. Blunted pressor and intramuscular metabolic responses to voluntary isometric exercise in multiple sclerosis. J Appl Physiol 2000; 88 (3): 871–80PubMed
37.
go back to reference Schwid SR, Thornton CA, Pandya S, et al. Quantitative assessment of motor fatigue and strength in MS. Neurology 1999; 53 (4): 743–50PubMed Schwid SR, Thornton CA, Pandya S, et al. Quantitative assessment of motor fatigue and strength in MS. Neurology 1999; 53 (4): 743–50PubMed
38.
go back to reference Chiara T, Carlos Jr J, Martin D, et al. Cold effect on oxygen uptake, perceived exertion, and spasticity in patients with multiple sclerosis. Arch Phys Med Rehabil 1998; 79 (5): 523–8PubMed Chiara T, Carlos Jr J, Martin D, et al. Cold effect on oxygen uptake, perceived exertion, and spasticity in patients with multiple sclerosis. Arch Phys Med Rehabil 1998; 79 (5): 523–8PubMed
39.
go back to reference Kent-Braun JA, Sharma KR, Miller RG, et al. Postexercise phosphocreatine resynthesis is slowed in multiple sclerosis. Muscle Nerve 1994; 17 (8): 835–41PubMed Kent-Braun JA, Sharma KR, Miller RG, et al. Postexercise phosphocreatine resynthesis is slowed in multiple sclerosis. Muscle Nerve 1994; 17 (8): 835–41PubMed
40.
go back to reference Kent-Braun JA, Sharma KR, Weiner MW, et al. Effects of exercise on muscle activation and metabolism in multiple sclerosis. Muscle Nerve 1994; 17 (10): 1162–9PubMed Kent-Braun JA, Sharma KR, Weiner MW, et al. Effects of exercise on muscle activation and metabolism in multiple sclerosis. Muscle Nerve 1994; 17 (10): 1162–9PubMed
41.
go back to reference Rice CL, Vollmer TL, Bigland-Ritchie B. Neuromuscular responses of patients with multiple sclerosis. Muscle Nerve 1992; 15 (10): 1123–32PubMed Rice CL, Vollmer TL, Bigland-Ritchie B. Neuromuscular responses of patients with multiple sclerosis. Muscle Nerve 1992; 15 (10): 1123–32PubMed
42.
go back to reference Chen WY, Pierson FM, Burnett CN. Force-time measurements of knee muscle functions of subjects with multiple sclerosis. Phys Ther 1987; 67 (6): 934–40PubMed Chen WY, Pierson FM, Burnett CN. Force-time measurements of knee muscle functions of subjects with multiple sclerosis. Phys Ther 1987; 67 (6): 934–40PubMed
43.
go back to reference Armstrong LE, Winant DM, Swasey PR, et al. Using isokinetic dynamometry to test ambulatory patients with multiple sclerosis. Phys Ther 1983; 63 (8): 1274–9PubMed Armstrong LE, Winant DM, Swasey PR, et al. Using isokinetic dynamometry to test ambulatory patients with multiple sclerosis. Phys Ther 1983; 63 (8): 1274–9PubMed
44.
go back to reference Cartlidge NE. Autonomic function in multiple sclerosis. Brain 1972; 95 (4): 661–4PubMed Cartlidge NE. Autonomic function in multiple sclerosis. Brain 1972; 95 (4): 661–4PubMed
45.
go back to reference Bakshi R, Shaikh ZA, Miletich RS, et al. Fatigue in multiple sclerosis and its relationship to depression and neurologic disability. Mult Scler 2000; 6 (3): 181–5PubMed Bakshi R, Shaikh ZA, Miletich RS, et al. Fatigue in multiple sclerosis and its relationship to depression and neurologic disability. Mult Scler 2000; 6 (3): 181–5PubMed
46.
go back to reference Murray TJ. Amantadine therapy for fatigue in multiple sclerosis. Can J Neurol Sci 1985; 12 (3): 251–4PubMed Murray TJ. Amantadine therapy for fatigue in multiple sclerosis. Can J Neurol Sci 1985; 12 (3): 251–4PubMed
47.
go back to reference Krupp LB, Alvarez LA, LaRocca NG, et al. Fatigue in multiple sclerosis. Arch Neurol 1988; 45 (4): 435–7PubMed Krupp LB, Alvarez LA, LaRocca NG, et al. Fatigue in multiple sclerosis. Arch Neurol 1988; 45 (4): 435–7PubMed
48.
go back to reference Bergamaschi R, Romani A, Versino M, et al. Clinical aspects of fatigue in multiple sclerosis. Funct Neurol 1997; 12 (5): 247–51PubMed Bergamaschi R, Romani A, Versino M, et al. Clinical aspects of fatigue in multiple sclerosis. Funct Neurol 1997; 12 (5): 247–51PubMed
49.
go back to reference Bakshi R. Fatigue associated with multiple sclerosis: diagnosis, impact and management. Mult Scler 2003; 9 (3): 219–27PubMed Bakshi R. Fatigue associated with multiple sclerosis: diagnosis, impact and management. Mult Scler 2003; 9 (3): 219–27PubMed
50.
go back to reference Elkins L, Pollina D, Scheffer S, et al. Effects of fatigue on cognitive functioning in multiple sclerosis. Neurology 1998; 50 Suppl.: A126 Elkins L, Pollina D, Scheffer S, et al. Effects of fatigue on cognitive functioning in multiple sclerosis. Neurology 1998; 50 Suppl.: A126
51.
go back to reference Sandroni P, Walker C, Starr A. ‘Fatigue’ in patients with multiple sclerosis: motor pathway conduction and event-related potentials. Arch Neurol 1992; 49 (5): 517–24PubMed Sandroni P, Walker C, Starr A. ‘Fatigue’ in patients with multiple sclerosis: motor pathway conduction and event-related potentials. Arch Neurol 1992; 49 (5): 517–24PubMed
52.
go back to reference Quesada JR, Talpaz M, Rios A, et al. Clinical toxicity of interferons in cancer patients: a review. J Clin Oncol 1986; 4 (2): 234–43PubMed Quesada JR, Talpaz M, Rios A, et al. Clinical toxicity of interferons in cancer patients: a review. J Clin Oncol 1986; 4 (2): 234–43PubMed
53.
go back to reference Neilly L, Goodin D, Goodkin D, et al. Side effect profile of interferon beta-1b in MS: results of an open label trial. Neurology 1996; 46: 552–4 Neilly L, Goodin D, Goodkin D, et al. Side effect profile of interferon beta-1b in MS: results of an open label trial. Neurology 1996; 46: 552–4
54.
go back to reference Moldofsky H, Lue FA, Eisen J, et al. The relationship of interleukin-1 and immune functions to sleep in humans. Psychosom Med 1986; 48 (5): 309–18PubMed Moldofsky H, Lue FA, Eisen J, et al. The relationship of interleukin-1 and immune functions to sleep in humans. Psychosom Med 1986; 48 (5): 309–18PubMed
55.
go back to reference Krueger JM, Walter J, Dinarello CA, et al. Sleep-promoting effects of endogenous pyrogen (interleukin-1). Am J Physiol 1984; 246 (6 Pt 2): R994–9 Krueger JM, Walter J, Dinarello CA, et al. Sleep-promoting effects of endogenous pyrogen (interleukin-1). Am J Physiol 1984; 246 (6 Pt 2): R994–9
56.
go back to reference Bertolone K, Coyle P, Krupp L, et al. Cytokine correlates of fatigue in MS. Neurology 1993; 43: 769S Bertolone K, Coyle P, Krupp L, et al. Cytokine correlates of fatigue in MS. Neurology 1993; 43: 769S
57.
go back to reference Chao CC, DeLaHunt M, Hu S, et al. Immunologically mediated fatigue: a murine model. Clin Immunol Immunopathol 1992; 64 (2): 161–5PubMed Chao CC, DeLaHunt M, Hu S, et al. Immunologically mediated fatigue: a murine model. Clin Immunol Immunopathol 1992; 64 (2): 161–5PubMed
58.
go back to reference Kent-Braun JA, Ng AV, Castro M, et al. Strength, skeletal muscle composition, and enzyme activity in multiple sclerosis. J Appl Physiol 1997; 83 (6): 1998–2004PubMed Kent-Braun JA, Ng AV, Castro M, et al. Strength, skeletal muscle composition, and enzyme activity in multiple sclerosis. J Appl Physiol 1997; 83 (6): 1998–2004PubMed
59.
go back to reference Roelcke U, Kappos L, Lechner-Scott J, et al. Reduced glucose metabolism in the frontal cortex and basal ganglia of multiple sclerosis patients with fatigue: a 18F-fluorodeoxyglucose positron emission tomography study. Neurology 1997; 48 (6): 1566–71PubMed Roelcke U, Kappos L, Lechner-Scott J, et al. Reduced glucose metabolism in the frontal cortex and basal ganglia of multiple sclerosis patients with fatigue: a 18F-fluorodeoxyglucose positron emission tomography study. Neurology 1997; 48 (6): 1566–71PubMed
60.
go back to reference Parry-Billings M, Blomstrand E, McAndrew N, et al. A communicational link between skeletal muscle, brain, and cells of the immune system. Int J Sports Med 1990; 11 Suppl. 2: S122–8 Parry-Billings M, Blomstrand E, McAndrew N, et al. A communicational link between skeletal muscle, brain, and cells of the immune system. Int J Sports Med 1990; 11 Suppl. 2: S122–8
61.
go back to reference Heilman K, Watson R. Fatigue. Neurol Network Commentary 1997; 1: 283–7 Heilman K, Watson R. Fatigue. Neurol Network Commentary 1997; 1: 283–7
62.
go back to reference van der Werf SP, Evers A, Jongen PJ, et al. The role of helplessness as mediator between neurological disability, emotional instability, experienced fatigue and depression in patients with multiple sclerosis. Mult Scler 2003; 9 (1): 89–94PubMed van der Werf SP, Evers A, Jongen PJ, et al. The role of helplessness as mediator between neurological disability, emotional instability, experienced fatigue and depression in patients with multiple sclerosis. Mult Scler 2003; 9 (1): 89–94PubMed
63.
go back to reference Tomassini V, Pozzilli C, Onesti E, et al. Comparison of the effects of acetyl L-carnitine and amantadine for the treatment of fatigue in multiple sclerosis: results of a pilot, randomised, double-blind, crossover trial. J Neurol Sci 2004; 218 (1–2): 103–8PubMed Tomassini V, Pozzilli C, Onesti E, et al. Comparison of the effects of acetyl L-carnitine and amantadine for the treatment of fatigue in multiple sclerosis: results of a pilot, randomised, double-blind, crossover trial. J Neurol Sci 2004; 218 (1–2): 103–8PubMed
64.
go back to reference van der Kamp W, Maertens de Noordhout A, Thompson PD, et al. Correlation of phasic muscle strength and corticomotoneuron conduction time in multiple sclerosis. Ann Neurol 1991; 29 (1): 6–12PubMed van der Kamp W, Maertens de Noordhout A, Thompson PD, et al. Correlation of phasic muscle strength and corticomotoneuron conduction time in multiple sclerosis. Ann Neurol 1991; 29 (1): 6–12PubMed
65.
go back to reference Johnson SK, DeLuca J, Natelson BH. Depression in fatiguing illness: comparing patients with chronic fatigue syndrome, multiple sclerosis and depression. J Affect Disord 1996; 39 (1): 21–30PubMed Johnson SK, DeLuca J, Natelson BH. Depression in fatiguing illness: comparing patients with chronic fatigue syndrome, multiple sclerosis and depression. J Affect Disord 1996; 39 (1): 21–30PubMed
66.
go back to reference Lana-Peixoto MA, Teixeira Jr AL, Haase VG. Interferon beta-1a-induced depression and suicidal ideation in multiple sclerosis. Arq Neuropsiquiatr 2002; 60 (3-B): 721–4PubMed Lana-Peixoto MA, Teixeira Jr AL, Haase VG. Interferon beta-1a-induced depression and suicidal ideation in multiple sclerosis. Arq Neuropsiquiatr 2002; 60 (3-B): 721–4PubMed
67.
go back to reference Joffe RT, Lippert GP, Gray TA, et al. Mood disorder and multiple sclerosis. Arch Neurol 1987; 44 (4): 376–8PubMed Joffe RT, Lippert GP, Gray TA, et al. Mood disorder and multiple sclerosis. Arch Neurol 1987; 44 (4): 376–8PubMed
68.
go back to reference Minden SL, Orav J, Reich P. Depression in multiple sclerosis. Gen Hosp Psychiatry 1987; 9 (6): 426–34PubMed Minden SL, Orav J, Reich P. Depression in multiple sclerosis. Gen Hosp Psychiatry 1987; 9 (6): 426–34PubMed
69.
go back to reference Sadovnick AD, Remick RA, Allen J, et al. Depression and multiple sclerosis. Neurology 1996; 46 (3): 628–32PubMed Sadovnick AD, Remick RA, Allen J, et al. Depression and multiple sclerosis. Neurology 1996; 46 (3): 628–32PubMed
70.
go back to reference Young RR. Treatment of spastic paresis. N Engl J Med 1989; 320 (23): 1553–5PubMed Young RR. Treatment of spastic paresis. N Engl J Med 1989; 320 (23): 1553–5PubMed
71.
go back to reference Lance JW. The control of muscle tone, reflexes, and movement: Robert Wartenberg Lecture. Neurology 1980; 30 (12): 1303–13PubMed Lance JW. The control of muscle tone, reflexes, and movement: Robert Wartenberg Lecture. Neurology 1980; 30 (12): 1303–13PubMed
72.
go back to reference Anacker SL, Di Fabio RP. Influence of sensory inputs on standing balance in community-dwelling elders with a recent history of falling. Phys Ther 1992; 72 (8): 575–81PubMed Anacker SL, Di Fabio RP. Influence of sensory inputs on standing balance in community-dwelling elders with a recent history of falling. Phys Ther 1992; 72 (8): 575–81PubMed
73.
go back to reference Black FO, Shupert CL, Horak FB, et al. Abnormal postural control associated with peripheral vestibular disorders. Prog Brain Res 1988; 76: 263–75PubMed Black FO, Shupert CL, Horak FB, et al. Abnormal postural control associated with peripheral vestibular disorders. Prog Brain Res 1988; 76: 263–75PubMed
74.
go back to reference Shabas D, Weinreb H. Preventive healthcare in women with multiple sclerosis. J Womens Health Gend Based Med 2000; 9 (4): 389–95PubMed Shabas D, Weinreb H. Preventive healthcare in women with multiple sclerosis. J Womens Health Gend Based Med 2000; 9 (4): 389–95PubMed
75.
go back to reference Rao SM, Leo GJ, Bernardin L, et al. Cognitive dysfunction in multiple sclerosis: I. frequency, patterns, and prediction. Neurology 1991; 41 (5): 685–91PubMed Rao SM, Leo GJ, Bernardin L, et al. Cognitive dysfunction in multiple sclerosis: I. frequency, patterns, and prediction. Neurology 1991; 41 (5): 685–91PubMed
76.
go back to reference Feinstein A, Kartsounis LD, Miller DH, et al. Clinically isolated lesions of the type seen in multiple sclerosis: a cognitive, psychiatric, and MRI follow up study. J Neurol Neurosurg Psychiatry 1992; 55 (10): 869–76PubMed Feinstein A, Kartsounis LD, Miller DH, et al. Clinically isolated lesions of the type seen in multiple sclerosis: a cognitive, psychiatric, and MRI follow up study. J Neurol Neurosurg Psychiatry 1992; 55 (10): 869–76PubMed
77.
go back to reference Sandyk R. Treatment with electromagnetic fields improves dual-task performance (talking while walking) in multiple sclerosis. Int J Neurosci 1997; 92 (1–2): 95–102PubMed Sandyk R. Treatment with electromagnetic fields improves dual-task performance (talking while walking) in multiple sclerosis. Int J Neurosci 1997; 92 (1–2): 95–102PubMed
78.
go back to reference Buyse B, Demedts M, Meekers J, et al. Respiratory dysfunction in multiple sclerosis: a prospective analysis of 60 patients. Eur Respir J 1997; 10 (1): 139–45PubMed Buyse B, Demedts M, Meekers J, et al. Respiratory dysfunction in multiple sclerosis: a prospective analysis of 60 patients. Eur Respir J 1997; 10 (1): 139–45PubMed
79.
go back to reference Gosselink R, Kovacs L, Ketelaer P, et al. Respiratory muscle weakness and respiratory muscle training in severely disabled multiple sclerosis patients. Arch Phys Med Rehabil 2000; 81 (6): 747–51PubMed Gosselink R, Kovacs L, Ketelaer P, et al. Respiratory muscle weakness and respiratory muscle training in severely disabled multiple sclerosis patients. Arch Phys Med Rehabil 2000; 81 (6): 747–51PubMed
80.
go back to reference Smeltzer SC, Lavietes MH, Cook SD. Expiratory training in multiple sclerosis. Arch Phys Med Rehabil 1996; 77 (9): 909–12PubMed Smeltzer SC, Lavietes MH, Cook SD. Expiratory training in multiple sclerosis. Arch Phys Med Rehabil 1996; 77 (9): 909–12PubMed
81.
go back to reference Smeltzer SC, Lavietes MH. Reliability of maximal respiratory pressures in multiple sclerosis. Chest 1999; 115 (6): 1546–52PubMed Smeltzer SC, Lavietes MH. Reliability of maximal respiratory pressures in multiple sclerosis. Chest 1999; 115 (6): 1546–52PubMed
82.
go back to reference Araki I, Matsui M, Ozawa K, et al. Relationship of bladder dysfunction to lesion site in multiple sclerosis. J Urol 2003; 169 (4): 1384–7PubMed Araki I, Matsui M, Ozawa K, et al. Relationship of bladder dysfunction to lesion site in multiple sclerosis. J Urol 2003; 169 (4): 1384–7PubMed
83.
go back to reference DasGupta R, Fowler CJ. Bladder, bowel and sexual dysfunction in multiple sclerosis: management strategies. Drugs 2003; 63 (2): 153–66PubMed DasGupta R, Fowler CJ. Bladder, bowel and sexual dysfunction in multiple sclerosis: management strategies. Drugs 2003; 63 (2): 153–66PubMed
84.
go back to reference Hawker KS, Frohman EM. Bladder, bowel, and sexual dysfunction in multiple sclerosis. Curr Treat Options Neurol 2001; 3 (3): 207–14PubMed Hawker KS, Frohman EM. Bladder, bowel, and sexual dysfunction in multiple sclerosis. Curr Treat Options Neurol 2001; 3 (3): 207–14PubMed
85.
go back to reference Stuifbergen AK. Health-promoting behaviors and quality of life among individuals with multiple sclerosis. Sch Inq Nurs Pract 1995; 9 (1): 31–50PubMed Stuifbergen AK. Health-promoting behaviors and quality of life among individuals with multiple sclerosis. Sch Inq Nurs Pract 1995; 9 (1): 31–50PubMed
86.
go back to reference Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273 (5): 402–7PubMed Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273 (5): 402–7PubMed
87.
go back to reference McCoy S, White L, Castellano V, et al. Cardiovascular risk modification after resistance training in subjects with multiple sclerosis [abstract]. Med Sci Sports Exerc 2004; 36 (5): S305 McCoy S, White L, Castellano V, et al. Cardiovascular risk modification after resistance training in subjects with multiple sclerosis [abstract]. Med Sci Sports Exerc 2004; 36 (5): S305
88.
go back to reference Molyneux PD, Barker GJ, Barkhof F, et al. Clinical-MRI correlations in a European trial of interferon beta-1b in secondary progressive MS. Neurology 2001; 57 (12): 2191–7PubMed Molyneux PD, Barker GJ, Barkhof F, et al. Clinical-MRI correlations in a European trial of interferon beta-1b in secondary progressive MS. Neurology 2001; 57 (12): 2191–7PubMed
89.
go back to reference McKenna PH, Herndon CD, Connery S, et al. Pelvic floor muscle retraining for pediatric voiding dysfunction using interactive computer games. J Urol 1999; 162 (3 Pt 2): 1056–62PubMed McKenna PH, Herndon CD, Connery S, et al. Pelvic floor muscle retraining for pediatric voiding dysfunction using interactive computer games. J Urol 1999; 162 (3 Pt 2): 1056–62PubMed
90.
go back to reference Abbruzzese G. The medical management of spasticity. Eur J Neurol 2002; 9 Suppl. 1: 30–4PubMed Abbruzzese G. The medical management of spasticity. Eur J Neurol 2002; 9 Suppl. 1: 30–4PubMed
91.
go back to reference DeBolt LS, McCubbin JA. The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. Arch Phys Med Rehabil 2004; 85 (2): 290–7PubMed DeBolt LS, McCubbin JA. The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. Arch Phys Med Rehabil 2004; 85 (2): 290–7PubMed
92.
go back to reference Husted C, Pham L, Hekking A, et al. Improving quality of life for people with chronic conditions: the example of t’ai chi and multiple sclerosis. Altern Ther Health Med 1999; 5 (5): 70–4PubMed Husted C, Pham L, Hekking A, et al. Improving quality of life for people with chronic conditions: the example of t’ai chi and multiple sclerosis. Altern Ther Health Med 1999; 5 (5): 70–4PubMed
93.
go back to reference Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS). Neurology 1983; 33 (11): 1444–52PubMed Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS). Neurology 1983; 33 (11): 1444–52PubMed
94.
go back to reference Balcer LJ. Clinical outcome measures for research in multiple sclerosis. J Neuroophthalmol 2001; 21 (4): 296–301PubMed Balcer LJ. Clinical outcome measures for research in multiple sclerosis. J Neuroophthalmol 2001; 21 (4): 296–301PubMed
95.
go back to reference Scheinberg L, Feldman F, Ratzker P. Self-assessment of neurological impairment in multiple sclerosis. Neurology 1986; 36 Suppl. 1: 284 Scheinberg L, Feldman F, Ratzker P. Self-assessment of neurological impairment in multiple sclerosis. Neurology 1986; 36 Suppl. 1: 284
96.
go back to reference White L, McCoy S, Castellano V, et al. Resistance training improves strength and functional capacity in persons with multiple sclerosis. Mult Scler 2004; 10: 1–7 White L, McCoy S, Castellano V, et al. Resistance training improves strength and functional capacity in persons with multiple sclerosis. Mult Scler 2004; 10: 1–7
97.
go back to reference Oken BS, Kishiyama S, Zajdel D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology 2004; 62 (11): 2058–64PubMed Oken BS, Kishiyama S, Zajdel D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology 2004; 62 (11): 2058–64PubMed
98.
go back to reference Gutierrez G, Chow J, Tillman M, et al. Effects of resistance training on gait kinematics of individuals with multiple sclerosis [abstract]. Med Sci Sports Exerc 2004; 36 (5): S266 Gutierrez G, Chow J, Tillman M, et al. Effects of resistance training on gait kinematics of individuals with multiple sclerosis [abstract]. Med Sci Sports Exerc 2004; 36 (5): S266
99.
go back to reference Nieves J, Cosman F, Herbert J, et al. High prevalence of vitamin D deficiency and reduced bone mass in multiple sclerosis. Neurology 1994; 44 (9): 1687–92PubMed Nieves J, Cosman F, Herbert J, et al. High prevalence of vitamin D deficiency and reduced bone mass in multiple sclerosis. Neurology 1994; 44 (9): 1687–92PubMed
100.
go back to reference Schwid SR, Goodman AD, Puzas JE, et al. Sporadic corticosteroid pulses and osteoporosis in multiple sclerosis. Arch Neurol 1996; 53 (8): 753–7PubMed Schwid SR, Goodman AD, Puzas JE, et al. Sporadic corticosteroid pulses and osteoporosis in multiple sclerosis. Arch Neurol 1996; 53 (8): 753–7PubMed
101.
go back to reference Formica CA, Cosman F, Nieves J, et al. Reduced bone mass and fat-free mass in women with multiple sclerosis: effects of ambulatory status and glucocorticoid use. Calcif Tissue Int 1997; 61 (2): 129–33PubMed Formica CA, Cosman F, Nieves J, et al. Reduced bone mass and fat-free mass in women with multiple sclerosis: effects of ambulatory status and glucocorticoid use. Calcif Tissue Int 1997; 61 (2): 129–33PubMed
102.
go back to reference Schapiro R. Multiple sclerosis: a rehabilitation approach to management. New York: Demos, 1991 Schapiro R. Multiple sclerosis: a rehabilitation approach to management. New York: Demos, 1991
103.
go back to reference O’Kroy JA, Coast JR. Effects of flow and resistive training on respiratory muscle endurance and strength. Respiration 1993; 60 (5): 279–83PubMed O’Kroy JA, Coast JR. Effects of flow and resistive training on respiratory muscle endurance and strength. Respiration 1993; 60 (5): 279–83PubMed
104.
go back to reference American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. Philadelphia (PA): Lippincott Williams and Wilkins, 2000 American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. Philadelphia (PA): Lippincott Williams and Wilkins, 2000
105.
go back to reference Poinchtera-Mulcare JA, Glaser RM, Mathews T. Maximal aerobic exercise in persons with MS. Clin Kinesiol 1983; 46 (4): 12–21 Poinchtera-Mulcare JA, Glaser RM, Mathews T. Maximal aerobic exercise in persons with MS. Clin Kinesiol 1983; 46 (4): 12–21
106.
go back to reference Sterman AB, Coyle PK, Panasci DJ, et al. Disseminated abnormalities of cardiovascular autonomic functions in multiple sclerosis. Neurology 1985; 35 (11): 1665–8PubMed Sterman AB, Coyle PK, Panasci DJ, et al. Disseminated abnormalities of cardiovascular autonomic functions in multiple sclerosis. Neurology 1985; 35 (11): 1665–8PubMed
107.
go back to reference Horvath SM. Exercise in a cold environment. Exerc Sport Sci Rev 1981; 9: 221–63PubMed Horvath SM. Exercise in a cold environment. Exerc Sport Sci Rev 1981; 9: 221–63PubMed
108.
go back to reference Stopka C. Equipment to enhance an adapted aquatic program. Palaestra 2001; 17 (1): 36–43 Stopka C. Equipment to enhance an adapted aquatic program. Palaestra 2001; 17 (1): 36–43
109.
go back to reference Peterson C. Exercise in 94 degrees F water for a patient with multiple sclerosis. Phys Ther 2001; 81 (4): 1049–58PubMed Peterson C. Exercise in 94 degrees F water for a patient with multiple sclerosis. Phys Ther 2001; 81 (4): 1049–58PubMed
110.
go back to reference Capodaglio P, Facioli M, Burroni E, et al. Effectiveness of a home-based strengthening program for elderly males in Italy: a preliminary study. Aging Clin Exp Res 2002; 14 (1): 28–34PubMed Capodaglio P, Facioli M, Burroni E, et al. Effectiveness of a home-based strengthening program for elderly males in Italy: a preliminary study. Aging Clin Exp Res 2002; 14 (1): 28–34PubMed
111.
go back to reference Burks J, Johnson K. Multiple sclerosis diagnosis, medical management, and rehabilitation. New York: Demos Medical Publishing, 2000 Burks J, Johnson K. Multiple sclerosis diagnosis, medical management, and rehabilitation. New York: Demos Medical Publishing, 2000
112.
go back to reference Miller PD. Fitness programming and physical disability. Champaign (IL): Human Kinetics, 1995 Miller PD. Fitness programming and physical disability. Champaign (IL): Human Kinetics, 1995
113.
go back to reference Feland JB, Myrer JW, Schulthies SS, et al. The effect of duration of stretching of the hamstring muscle group for increasing range of motion in people aged 65 years or older. Phys Ther 2001; 81 (5): 1110–7PubMed Feland JB, Myrer JW, Schulthies SS, et al. The effect of duration of stretching of the hamstring muscle group for increasing range of motion in people aged 65 years or older. Phys Ther 2001; 81 (5): 1110–7PubMed
114.
go back to reference Madanmohan TDP, Balakumar B, Nambinarayanan TK, et al. Effect of yoga training on reaction time, respiratory endurance and muscle strength. Indian J Physiol Pharmacol 1992; 36 (4): 229–33PubMed Madanmohan TDP, Balakumar B, Nambinarayanan TK, et al. Effect of yoga training on reaction time, respiratory endurance and muscle strength. Indian J Physiol Pharmacol 1992; 36 (4): 229–33PubMed
115.
go back to reference Noronha MJ, Vas CJ, Aziz H. Autonomic dysfunction (sweating responses) in multiple sclerosis. J Neurol Neurosurg Psychiatry 1968; 31 (1): 19–22PubMed Noronha MJ, Vas CJ, Aziz H. Autonomic dysfunction (sweating responses) in multiple sclerosis. J Neurol Neurosurg Psychiatry 1968; 31 (1): 19–22PubMed
Metadata
Title
Exercise and Multiple Sclerosis
Authors
Lesley J. White
Rudolph H. Dressendorfer
Publication date
01-12-2004
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 15/2004
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.2165/00007256-200434150-00005

Other articles of this Issue 15/2004

Sports Medicine 15/2004 Go to the issue

Acknowledgments

Acknowledgement