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Phoebe Sansom. Physiotherapy and MS. Exercise not only changes the body. It changes the mind. Your attitude and your mood. Our bodies were made to move and movement is really good for us.
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Phoebe Sansom Physiotherapy and MS
Exercise not only changes the body. It changes the mind. Your attitude and your mood.
Our bodies were made to move and movement is really good for us. As such, Physical activity has long been recognized as an important part of maintaining a healthy lifestyle. I’m sure you’ve all heard of the phrase ‘Move it or lose it’.
There are so many benefits! • The Australian Government provides all Australians with advice around being physically active. These guidelines recommend that all Australians, regardless of ability, should be aiming for 150-300 minutes of moderate intensity physical activity per week as well as 2 sessions of muscle strengthening. Moderate intensity physical activity will be different for everyone- it might be walking the dog, riding your bike to the shops or doing the gardening. The key is you should be a little puffed but still able to talk. • It is recommended that - Doing any physical activity is better than doing none! • Many Australians do not meet the recommended amount of physical activity, we are just not active enough. This is the same for people in Australia with MS. So for many of us the take home message will be MOVE MORE! • ‘If you are currently not physically active, start by doing something, then do a some more, and gradually build up to the recommended amount. Aim to be active on most, preferably all, days of the week!
The Canadian government have released physical activity guidelines specific to MS. • They recommend that for people with mild to moderate MS you should be aiming for 30 mins of moderate intensity aerobic exercise 2 x per week and 2 strength training sessions.
Chances are I didn’t need to tell you that being active is good for you. Chances are you already new that! So if you know its good for you, what's stopping you? It is highly likely that the things that are stopping 60% of Australians from being as active as they should, are the same things that are stopping you! In 2015, a research study was conducted to look at what makes it easy or hard for people with MS to exercise or be physically active. Access to the right environment is important so it can be harder to exercise if you don’t have access to a gym or the equipment you need to do your program. It can be harder to exercise if you don’t get advice from a health professional or if the advice you get is conflicting or confusing. Personal challenges such as managing fatigue can make it harder to exercise. And many people are apprehensive about navigating the road to becoming physically active. If any of these are reasons are stopping you from engaging in physical activity or exercise, start to think about how you might overcome them? Is it investing in some sports equipment, is it coming to talk to me in MS clinic? Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences. Learmonth and Motl 2015.
It is important to know what can make it easier to exercise. We know that people who have access to the right environment such as a gym, a pool or some equipment at home are more likely to exercise. Those who have people around them to support them and encourage them are more likely to exercise. And those who exercise with others as a form of social interaction. Those who can find an activity that they enjoy and feel a sense of satisfaction from it are more likely to continue being active. And the feeling of success is what motivates us to continue.
In case there are some of you in the audience that still have a feeling of worry when thinking about how exercise might effect you. Exercise training in MS has been proven safe! A research study including nearly 1300 people with MS showed that exercise training did NOT increase the number of relapses and there were NO more adverse events. This was a really big research study and should therefore alleviate any uncertainty regarding exercising with MS. There is now a growing number of research studies supporting different types of exercises and benefits for people with MS Exercise training was not associated with an increased risk of relapse, and risk of AEs was not higher than in healthy populations. This evidence should alleviate uncertainty regarding the safety of exercise training in MS. Pilutti, Platta, et al. 2014.
It has been shown by Gunn and his associates (2015) that balance can be improved through exercising. • The key take home message here is that in order to see these improvements it is important to practice balance exercises that are right for you. • For this reason I would recommend anyone wanting to focus on improving their balance to consult a physiotherapist. You can do this through the MS clinic, or you can talk to your GP about getting a referral to see a physiotherapist at the local community centre or a private physiotherapist. You should receive guidance on whether it is best for you to practice these exercises at home by yourself or whether it may be best to have a few session where you can be guided through the exercises before progressing to do them at home. Systematic review: the effectiveness of interventions to reduce falls and improve balance in adults with multiple sclerosis Gunn H, Markevics S, Haas B, Marsden J, Freeman JArchives of Physical Medicine and Rehabilitation 2015
WALKING SPEED AND DISTANCE BALANCE
2015 was a busy year for research in MS. Peason, Deiberg and Smart investigated whether exercise could improve walking ability in people with MS. They found that if people who exercised for greater than two week improved their walking speed and endurance. That is how fast and how far they could walk. Not bad hey! You can get these benefits from a wide variety of exercises including aerobic and endurance training, resistance training, aquatics, yoga, etc. Exercise as a therapy for improvement of walking ability in adults with multiple sclerosis: a meta-analysis Pearson M, Dieberg G, Smart N Archives of Physical Medicine and Rehabilitation 2015
WALKING SPEED AND DISTANCE BALANCE FATIGUE
And next, the F word. Fatigue. One of the common reason that may stop you from exercising. Well news flash time… There was a research study done including 1600 people with MS that supported the idea that exercise may be a promising treatment to reduce fatigue, without any side effects. Exercise therapy can induce physiological and psychological changes that may counter these mechanisms and reduce fatigue in MS. Having said that it is about finding the right type and amount of exercise for you – this may be something a professional can help you with. There may be some research in this area in the future so stay tuned. But for now the myth is busted and the F word is no longer a reason not to exercise. • Heine M, van de Port I, Rietberg MB, van Wegen EEH, Kwakkel G, 2015. Exercise therapy for fatigue in multiple sclerosis.
WALKING SPEED AND DISTANCE BALANCE FATIGUE DEPRESSION
And lastly Adamson and Collegues have published a paper that say exercise, particularly when meeting physical activity guidelines, can improve depressive symptoms in adults with neurological disorders. So this slide hear proves that “Exercise can not only change the body, it changes the mind, your attitude and your mood”. The effect of exercise on depressive symptoms in adults with neurological disorders: a systematic review and meta-analysis Adamson BC, Ensari I, MotlRWArchives of Physical Medicine and Rehabilitation 2015
Types of exercise.. Types of exercise
There are many manymany different ways that you can be physically active or exercise. The list is endless. And there is something out there to suit everyone. Some of the common ways to exercise might be to join a Group fitness class – this might be at the local park or local gym. There are even some Monash Health community centres that run Exercise groups just for people with MS. You might attend a local swimming pool to do pool walking, swimming or an aquatic class. You might get a program written up and go to the local gym. You might have a treadmill or an exercise bike at home. You might watch an exercise DVD and follow along on your lounge room floor You might have someone such as a carer that comes to your house and helps you practice your home based exercise program You might do yoga or pilates classes You might meet a friend a the local park and walk laps with your dogs Or you might have equipment at home that helps you stand for longer periods of time.
The right type of exercise for you is going to be the type of exercise that you enjoy!! And that is the most important. It might take a few trials of different types of exercise but there is something out there for everyone.
After hearing all of the benefits of exercise and how they can help you maintain a happy and healthy life - what better time than now to commit to a physical activity goal. This is a great time to think about something physical that you would like to improve. Is it something that you have been putting off? Is there something that has been holding you back?Perhaps you want to improve your balance? Perhaps you want to be able to walk the dog for 30 mins per day? Perhaps you want meet the recommended physical activity guidelines?I want you to think of something and create a clear image of it in your mind.
NOW YOU NEED TO COME UP WITH SMALL STEPS TO WORK TOWARDS ACHIEVING YOUR GOAL.FIRST YOU NEED TO WRITE IT DOWN. PUT IT IN YOUR PHONE, PUT IT ON THE FRIDGE, WRITE A STICKY NOTE ON YOUR BATHROOM MIRROR. NEXT THINK ABOUT WHAT SMALL STEPS ARE GOING TO HELP YOU… PERHAPS YOU NEED TO ENLIST A FRIEND FOR SUPPORT?PERHAPS YOU NEED A PHYSIOTHERAPISTS EXPERTISE TO WRITE YOU A PROGRAM? PERHAPS YOU NEED TO BITE THE BULLET AND JOIN THE GYM.ACHIEVING YOUR GOAL DOESN’T HAPPEN OVERNIGHT SO IT IS THE SMALL STEPS ADD UP TO GETTING THERE!SHOULD YOU NEED ANY ADVICE ON COMING UP WITH A GOAL OR EXERCISE PLAN, ANY ADVICE ON HOW TO WORK TOWARDS YOUR GOAL OR HELP SELECTING THE MOST APPROPRIATE ACTIVITY OR EXERCISE FOR YOU, IT IS BEST TO CONSULT A HEALTH PROFESSIONAL FOR ADVICE. YOU CAN DO THIS VIA THE PHYSIOTHERAPIST AT THE MMC MS CLINIC, VIA A REFERRAL FROM YOUR GP TO ATTEND THE LOCAL COMMUNITY CENTRE OR A PRIVATE PHYSIOTHERAPIST. NOW IS TIME TO TAKE ACTION. START. SO SOMETHING. ANYTHING. THE SMALLEST ACTION WILL KICKSTART A WAVE OF MOMENTUM!
