with an individual’s endurance.
Aggressive training, on the
other hand, isn’t well-tolerated
and can result in injury, severe
fatigue and MS exacerbations,
she cautions.
Other MS-specific strategies
also apply. “People with MS
tend to have one weak side
of the body and one strong
side,” says Dr. Filipi, a nurse
practitioner at Neurological and
Spinal Surgery in Lincoln, Neb.,
and an assistant professor at the
University of Nebraska Medical
Center’s College of Nursing in
Omaha.
To avoid causing harm, it’s
best to exercise one side first,
then the other. “If you do both
sides at the same time, the
strong side takes over and it gets
even stronger,” she says. “And
the weak side doesn’t work like
it should; it gets weaker.” It’s
also wise to lift less weight or do
fewer repetitions on the weak
side. “But you have to build up
that weak side, and that’s where
all of this specialized knowledge
comes in.”
A tailored regimen could
entail lifting weights, but it also
may include core strengthening
of abdominal and back muscles.
Before embarking on any
exercise program, people
with MS should be properly
evaluated for strength and
balance, which may include
the role of visual interruption,
says Kathleen Brandfass, MS,
PT, director of neuro and
geriatric outpatient services at
the University of Pittsburgh
Medical Center. “We also need
to monitor their level of heat
sensitivity,” says Brandfass, who
serves on the Clinical Advisory
Board of the Society’s Western
Pennsylvania Chapter.
Pushing past obstacles
For people with chronic illnesses,
however, insurers often limit
the number of physical therapy
treatments, and the cost of these
services becomes a deterrent
for some, Dr. Filipi notes.
Gym memberships can also be
expensive. In addition, exercise
programs and fitness facilities
don’t always accommodate
people with disabilities.
In some parts of the
country, people overcome
these challenges by connecting
people with community-based
exercise classes and trainers.
The Society has partnered with
Total Woman Fitness Center in
Bakersfield, Calif., for example,
to create an exercise class with
strength training, stretching
and cardiovascular activities for
women with MS. In addition,
Total Woman facilitates the
fitness component of Living
Well with MS, a program for
people who have been newly
diagnosed.
r
COURTESY OF THE BOSTON HOME
