The Importance of Physical Fitness in Multiple Sclerosis

The present review paper provides an overview on the importance of physical fitness in persons with Multiple Sclerosis (MS). We first present a model describing a cyclical association among physical inactivity, physiological deconditioning, and worsening of MS over time. We then provide a comprehensive review of research indicating extensive physiological deconditioning in cardiorespiratory, muscular, motor, and morphological domains of physical fitness among those with MS compared with controls and as a function of disability status. There further is substantial evidence for associations between physiological deconditioning and a variety of consequences of MS (e.g. outcomes of brain structure and function, ambulation, cognition, and fatigue), emphasizing the importance of counteracting and maintaining all domains of physical fitness. Exercise training may be an effective approach for improving physical fitness and managing secondary consequences among persons with MS. To that end, researchers have recently developed evidence-based physical activity guidelines indicating that adults with MS should participate in 2 weekly sessions of 30 minutes of moderate intensity aerobic activity to improve aerobic capacity and 2 weekly sessions of resistance training to improve muscular fitness. We believe that these guidelines provide an important basis for the prescription of exercise training by clinicians as a therapeutic approach for managing many of the consequences of MS.