Recent research in relation to exercise and activity in MS and how to get active by Jane Petty

Recent research in relation to exercise and activity in MS and

how to Get Active Jane Petty

National Programme Lead Physiotherapy MS Society [email protected]

Physical activity is:• Any body movement that works your muscles and uses more

energy than you use when resting 2008 Physical Activity Guidelines for Americans

• Bodily movement that enhances health

Exercise is:• Physical activity that is planned, structured, and repetitive• Utilized to improve health, maintain fitness and for physical

rehabilitationhttp://medical-dictionary.thefreedictionary.com/exercise

History of Exercise in MS

Previous perspective• Restrict activities• Normal physical & psychological stress ↑’s disease activity• Exercise causes symptom instability and ↑’s fatigue

Current perspective• Increased activity, in part, is responsible for an almost

normal life expectancy for most pwMS

The impact of Pilates was tested using a randomized controlled trial

of 23 people with MS who use wheelchairs.

One group of participants attended 12 weeks of Pilates classes and was also asked to practice Pilates in their own home

. A second group acted as a control and didn’t receive any additional treatment to their usual care.

Intervention

6 weeks of Pilates twice a week

Followed by 6 weeks of Pilates once a week

Attendance was 85% in first block 86% in second block due to one participant having a relapse

Assessments at baseline, after 6 weeks,12 weeks, 24 weeks

conclusion

Pilot study

attendance was high

13 out of 14 would like to continue

Strong positive reaction to the experience

Wasn’t powered sufficiently for statistical significant change other than pain in shoulders and arms

However leaning sideways, posture, function and quality of life had a trend towards small to large improvements

Walking impairment in patients with MS exercise training as a treatment

option Motle et al 2010

exercise training as a rehab approach for managing walking impairment and improving walking function in persons with MS. physical activity and exercise training has been associated with beneficial effects on walking function in persons with MSthe combined effects of exercise training and pharmacological agents on walking mobility in MS. Exercise training and physical activity might hold significant potential for the management of progressive mobility disability in MS.

Exercise in MS (EXIMS)MS Society funded research at Sheffield Hallam University results to be published

Week 1 - 6 2 x week supervised exercise 1x week exercise at home

Week 7 -12 1 x week supervised exercise 2 x week exercise at home

assessment at baseline, week 13-14 and 9 months

Exercise counselling, consciousness raising, goal setting, social support.

exercise review, review goals, future exercise options, what you have achieved so far

EXIMS economic benefits

How much does the intervention cost

Does it provide additional benefits

Does it provide value for money for the NHS

QUALY Quality added life years

Outpatient visits 2.2/1.2

GP visits 2.1/0.7 £18 per visit

Intervention cost 67.55 per 3 people

Outpatient costs £125 per visit

active living

home exercise

sport

dance

play

recreational activities

gym exercise/ equipment

water-based

seated exercise

exercise dvd's

computer Games wii

tai-chi / yoga

People misunderstanding MS.Health professionals not thinking out

of the box.Lack of early intervention.

Funding issues and postcode lottery.Risk Averse!

National organisation with branches all over EnglandProvides sport and challenging pursuits for people with many physical disabilities including MSThese include:

• It is not about creating elite sportsmen and women. • It is about trying something new and different. • It is about the adrenaline rush, putting the buzz back into life.• To inspire the thought, "If I can do this, what else can I achieve?"

scuba diving, sailing, archery, angling, abseiling, quad-biking, gliding, canoeing, clay pigeon shooting, go-karting, land-yachting, wheelchair tennis and many more.

“I really enjoyed meeting all those taking part and was re-assured about my future by seeing how everyone handled some different situations”.

“Just had a glorious Sportability day, We did clay pigeon shooting followed by archery followed by quad biking”.

No word of a lie, I started to become conscious of deep core muscles that were flexing again and I could feel right from week 1 a sort of iron belt starting to form around my middle which was helping me balance and straighten my posture. Wow, I thought, suddenly conscious of my movement again after so long.’’

FEEDBACK

MS Activity days

These give people with MS with their families the opportunity to try or find out about lots of different activities they may not have thought of or tried before such as:-ArcheryBocciaClimbing wallPilatesYogaShooting

• Horse riding

IFI

Sarah Collyer’s Project

Funded by the MS Society to get the branches to look at developing new exercise and activity opportunities for PwMSBranch guidance on how to set up ex class and activity opportunitiesGuidance for fitness instructors, leisure facilities on how to support someone with MS to be Physically activeFitness instructor training package Access audit for leisure centres for people with disabilities

I needed a fresh start and to look at leisure and activities in

a different way.

Thinking outside the box and be determined to find ways around barriers.

Be prepared to make adjustments.

Find what suites you and is enjoyable.

Network with other PWMS.

Find the right club or organisation.