"No intervention has proven effective in modifying long-term disease prognosis in multiple sclerosis, but exercise therapy is considered to be an important part of symptomatic and supportive treatment for these patients," Uitdehaag says.
Exercise therapy probably does not affect the disease process itself, according to co-author Dr. Gert Kwakkel. He says exercise may help "patients learn to compensate (for) their existing deficits. Systematic physical training may reduce disuse, in particular for those who suffer from fatigue."
The average of age of patients in the reviewed studies ranged from 34 to 51 years old, with varying types and severities of multiple sclerosis. The researchers suggest future studies should include a greater number of older individuals, severely disabled patients and patients who have been living with the disease for more than 18 years.
The studies also included a wide range of exercise programs and definitions of improved health and fitness, making it difficult to decide what kinds of exercise are best for MS patients. Uitdehaag and colleagues found no evidence that any specific exercise therapy programs were better for health and mobility than other exercise programs.
The researchers also found no signs in any of the studies that exercise therapy was harmful to the health of MS patients. The National Multiple Sclerosis Society suggests that MS patients exercise with frequent rest breaks, since heat can aggravate MS symptoms.
"With this type of exercise-rest-exercise patterns, physical therapy may be quite effective, with very good results," according to the Society's recommendations.
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Contact: Bernard Uitdehaag
bmj.uitdehaag@vumc.nl
Center for the Advancement of Health
22-Feb-2005