Lifestyle physical activity should be as central to the health-promoting habits of patients with multiple sclerosis (MS) as exercise training, according to one expert (Motl RW. Mult Scler. 2014 March 6. Epub ahead of print). Dr Motl cites many studies—including some he was a coinvestigator in—to show that increasing self-selected physical activities can significantly improve the health of patients with MS.
“The time is ripe that researchers and clinicians might consider the paradigm shift away from solely supervised and prescriptive exercise training and toward embracing lifestyle physical activity as another therapeutic strategy in the comprehensive care of MS,” wrote Robert Motl, PhD, Associate Professor, Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign. “Excitedly, the author is interested to see if the MS community will embrace ‘the new kid on the MS block,’” he wrote.
A Paradigm Shift in MS Is Crucial
The central problem is, Dr Motl suggests, that patients with MS do not do much physical activity, despite the well-established benefits to individuals’ overall health and quality of life. Supervised exercise training can have significant benefits for this patient population, but approximately 80% of patients with MS do not meet the recommended levels of physical activity, he emphasizes.
A paradigm shift toward daily physical activities is necessary, similar to what has taken place in the general population. Lifestyle physical activity is personalized and self-managed, and rather than focusing on physical fitness, which does not appeal to many people, is geared to overall health promotion, observed Dr Motl.
It also fits in much more seamlessly with patients’ lives since it can take place as part of everyday life and these activities are “accumulated in short bouts over the day as part of one’s life rather than one long, continuous bout [of structured exercise].… Accordingly, lifestyle physical activity would seem ideal for those with MS, considering [this population‘s] rates of sedentary behavioral and physical inactivity.”
Dr Motl describes the difference between structured exercise and lifestyle physical activities, discussing the importance of this paradigm shift and why it is so important, and outlining behavioral intervention that may help to increase physical activities.
This approach has been shown to improve everything from walking mobility to pain in people with MS, Dr Motl emphasizes. Furthermore, it has already been embraced in the general population, and can be implemented cost-effectively and on a large scale for people with MS and other chronic conditions, according to Dr Motl.
He and several coinvestigators have conducted a randomized controlled trial, for example, demonstrating that Internet-delivered encouragement of increased lifestyle physical activity among people with MS reduces their fatigue severity and its physical impacts, and also reduces depression and anxiety (Pilutti L, et al. Mult Scler. 2013 Sept 5. Epub ahead of print).
In addition, the intervention—which involves a website demonstrating the benefits of lifestyle physical activity and one-on-one video coaching by exercise professionals—also improved cognition and performance on the 6-minute walk test (Sandroff BM, et al. J Neurol. 2014;261: 363-372).