Understanding multiple sclerosis

Multiple sclerosis (MS) is one of the most common neurological disorders and causes of disability in young adults. It is also one of the most unpredictable.

The severity of the course of MS and the symptoms can vary widely among individuals.

With May designated International Multiple Sclerosis Awareness Month, the Biokinetics Association of South Africa (BASA) believes it is important for there to be greater understanding of the way management of the disease is changing.

Who is affected?

Multiple Sclerosis South Africa estimates that there are about 5 000 MS sufferers in the country and around 2,5 million around the world, with women outnumbering men by two to one.

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MS symptoms can start at anywhere between 10 and 80 years of age, but onset is usually between the ages of 20 and 40.

What are the symptoms?

According to Areta Potgieter, an executive member of BASA and a practising biokineticist, the severity of the course of MS as well as the symptoms can vary widely among individuals. These include extreme fatigue, lack of coordination, weakness, tingling, impaired sensation, vision problems, bladder problems, cognitive impairment and psychological symptoms such as depression, anxiety, tension and anger.

For some people, MS involves periods of relapse and remission, meaning that it can get better for a while, and then can attack again from time to time. For others, it gets steadily worse with time. Some may feel and seem healthy for many years following diagnosis, while others may be severely debilitated very quickly.

How exercise helps people with MS

“One of the most profound changes in MS treatment and management is related to exercise. For decades, people with MS were advised to avoid excessive physical activity and exercise because of concerns about worsening the disease’s activity,” says Potgieter.

“However, recent studies indicate that not only do people with MS tolerate physical exercise, it is also helpful in managing symptoms, preventing complications and may even have a beneficial impact on the progression of the disease and its symptoms – both physical and mental.”

For example, fatigue is one of the most common and devastating symptoms of MS, affecting between 75 and 90% of all MS patients. This can negatively affect their daily functioning and quality of life. However, many avoid physical activity to try and reduce their symptoms of fatigue even though this could actually enhance fatigue.

“Numerous studies have shown that certain types and intensity of exercise, including walking and other aerobic activities and, to a lesser extent, resistance and strength training, may provide relief and could play a significant part in fatigue management, while also improving endurance, muscle tone and posture stability,” Potgieter says.

She advises that people with MS follow a tailor-made exercise programme.

“It is important that a physical training programme is tailored to the individual needs and symptoms of each MS patient. It should take account of the progression of the disease, as well as the individual’s degree of disability, age, and concomitant diseases. Importantly, it also has to ensure that the patient is not overstrained,” concludes Potgieter.

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