Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct;26(12):1459-1469.
doi: 10.1177/1352458520915629. Epub 2020 Apr 23.

Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course

Rosalind Kalb  1 , Theodore R Brown  2 , Susan Coote  3 , Kathleen Costello  1 , Ulrik Dalgas  4 , Eric Garmon  1 , Barbara Giesser  5 , June Halper  6 , Herb Karpatkin  7 , Jennifer Keller  8 , Alexander V Ng  9 , Lara A Pilutti  10 , Amanda Rohrig  11 , Paul Van Asch  12 , Kathleen Zackowski  1 , Robert W Motl  13
Affiliations

Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course

Rosalind Kalb et al. Mult Scler. 2020 Oct.

Abstract

Objectives: To provide clinicians who treat multiple sclerosis (MS) patients with evidence-based or expert opinion-based recommendations for promoting exercise and lifestyle physical activity across disability levels.

Methods: The National MS Society ("Society") convened clinical and research experts in the fields of MS, exercise, rehabilitation, and physical activity to (1) reach consensus on optimal exercise and lifestyle physical activity recommendations for individuals with MS at disability levels 0-9.0 on the Expanded Disability Status Scale (EDSS) and (2) identify and address barriers/facilitators for participation.

Recommendations: Based on current evidence and expert opinion, the Society makes the following recommendations, endorsed by the Consortium of Multiple Sclerosis Centers:Healthcare providers should endorse and promote the benefits/safety of exercise and lifestyle physical activity for every person with MS.Early evaluation by a physical or occupational therapist or exercise or sport scientist, experienced in MS (hereafter referred to as "specialists"), is recommended to establish an individualized exercise and/or lifestyle physical activity plan.Taking into account comorbidities and symptom fluctuations, healthcare providers should encourage ⩾150 min/week of exercise and/or ⩾150 min/week of lifestyle physical activity.Progress toward these targets should be gradual, based on the person's abilities, preferences, and safety.If disability increases and exercise/physical activity becomes more challenging, referrals to specialists are essential to ensure safe and appropriate prescriptions.When physical mobility is very limited, exercise should be facilitated by a trained assistant.

Keywords: Multiple sclerosis; disability; exercise; lifestyle physical activity; physical activity; recommendations; wellness.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Rosalind Kalb received a consulting fee from the National Multiple Sclerosis Society for the preparation of this manuscript. Dr Susan Coote receives funding from Novartis Pharmaceuticals to develop an exercise program for MS patients. The remaining authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Dunn M, Bhargava P, Kalb R. Your patients with multiple sclerosis have set wellness as a high priority—And the National MS Society is responding. US Neurol 2015; 11(2): 80–86.
    1. Motl RW, Mowry EM, Ehde DM, et al. Wellness and multiple sclerosis: The National MS Society establishes a Wellness Research Working Group and research priorities. Mult Scler 2018; 24(3): 262–267. - PMC - PubMed
    1. Petajan JH, Gappmaier E, White AT, et al. Impact of aerobic training on fitness and quality of life in multiple sclerosis. Ann Neurol 1996; 39(4): 432–441. - PubMed
    1. Petajan JH, White AT. Recommendations for physical activity in patients with multiple sclerosis. Sports Med 1999; 27(3): 179–191. - PubMed
    1. Bouchard C, Shephard R. Physical activity, fitness, and health: The model and key concepts. In: Bouchard C, Shephard RJ, Stephens T. (eds) Physical activity, fitness, and health: International proceedings and consensus statement. Champaign, IL: Human Kinetics Publishers, 1994, pp. 77–88.