Exercise in patients with multiple sclerosis - 14/09/17

Doi : 10.1016/S1474-4422(17)30281-8

Robert W Motl, ProfPhD ^a,^⁎ , Brian M Sandroff, PhD ^a, Gert Kwakkel, ProfPhD ^b,^c, Ulrik Dalgas, PhD ^d, Anthony Feinstein, ProfPhD ^e,^f, Christoph Heesen, ProfMD ^g, Peter Feys, PhD ^h, Alan J Thompson, ProfMD ⁱ

^a Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA

^b Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam Movement Sciences and Amsterdam Neuroscience, Amsterdam, Netherlands

^c Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA

^d Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark

^e Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

^f Department of Psychiatry, University of Toronto, Toronto, ON, Canada

^g Institute of Neuroimmunology and Department of Neurology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany

^h Rehabilitation Research Center, Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium

ⁱ Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK

^* Correspondence to: Prof Robert W Motl, Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA Correspondence to: Prof Robert W Motl, Department of Physical Therapy University of Alabama at Birmingham Birmingham AL 35294 USA

Summary

Exercise can be a beneficial rehabilitation strategy for people with multiple sclerosis to manage symptoms, restore function, optimise quality of life, promote wellness, and boost participation in activities of daily living. However, this population typically engages in low levels of health-promoting physical activity compared with adults from the general population, a fact which has not changed in the past 25 years despite growing evidence of the benefits of exercise. To overcome this challenge, the main limitations to promoting exercise through the patient–clinician interaction must be addressed. These limitations are the inadequate quality and scope of existing evidence, incomplete understanding of the mechanisms underlying the beneficial effects of exercise in people with multiple sclerosis, and the absence of a conceptual framework and toolkit for translating the evidence into practice. Future research to address those limitations will be essential to inform decisions about the inclusion of exercise in the clinical care of people with multiple sclerosis.

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