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Thread: Exercise Is a Must With Multiple Sclerosis & SCI TOO?

  1. #1

    Exercise Is a Must With Multiple Sclerosis & SCI TOO?

    QUESTION 1. (??) Wouldn't this also hold true for SCI individuals?

    "In the past we have thought of exercise as primarily a way to maintain the health of the MS patient," he says. "But in the future we may give an 'exercise prescription' that will actually stimulate the nervous system to improve and perhaps even regenerate cells."


    Question 2. (??) Again.....SCI INDIDUALS ALSO?


    The body apparently accumulates chilled blood in the legs and circulates it from the feet up during exercise, thus cooling off the core body temperature. "Exercise does not damage MS patients," Dr. Petajan declares. "It does help people feel more competent, improves mood, and possibly, because of enhanced pelvic strength, even improves bowel and bladder symptoms."


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    Exercise Is a Must With Multiple Sclerosis

    Maxine Rock (Maxine Rock is a freelance medical writer.)

    Several times a night, Marianne Fontaine has to ask her 13-year-old daughter, Amber, to help her turn over in bed. Marianne, 39, is a single mom from Florida who has multiple sclerosis (MS). When her insurance company was paying for exercise therapy, Fontaine says she was much stronger and could turn over by herself. But now, benefits for the therapy have run out, and she says her MS has deteriorated to the point where she may have to enter a nursing home when Amber goes to college. She sighs, "Insurance companies don't understand that with MS, you must have exercise."

    According to a recent study by MS expert Jack H. Petajan, MD, professor of neurology at the University of Utah in Salt Lake City, Marianne is right. Dr. Petajan's study finally elevates the link between physical activity and MS from anecdote to science, and shows that exercise is an important treatment that can improve the quality of life for patients with MS.

    "In the past we have thought of exercise as primarily a way to maintain the health of the MS patient," he says. "But in the future we may give an 'exercise prescription' that will actually stimulate the nervous system to improve and perhaps even regenerate cells."


    Exercise Revolution

    Getting the go-ahead for exercise from MS experts is revolutionary when it comes to the concepts of care for this neurological disease. Traditionally, people with MS were told to take it easy, because the increased body heat from exercise temporarily worsened symptoms. Even a half-degree rise in temperature can cause what is known as Uthoff's phenomenon-blurred vision-in MS patients.

    But Dr. Petajan says pre-exercise cooling, such as sitting in a tub of tepid water for about 20 minutes, can counteract this effect. The body apparently accumulates chilled blood in the legs and circulates it from the feet up during exercise, thus cooling off the core body temperature. "Exercise does not damage MS patients," Dr. Petajan declares. "It does help people feel more competent, improves mood, and possibly, because of enhanced pelvic strength, even improves bowel and bladder symptoms."

    The National Multiple Sclerosis Society, which helped sponsor Dr. Petajan's study, agrees. The society is actively trying to convince insurance companies to pay for lifetime exercise therapy for people with MS. Arney Rosenblat, a Society spokesperson, says long-term exercise insurance benefits would make independent living possible for people like Fontaine. "It makes sense and saves money to help people remain able to do things for themselves," she notes.


    Ski Champ Shows Way

    One of the first people to campaign for using exercise as a way to treat MS was Jimmie Heuga, a US Olympic skiing champion who was diagnosed with MS in the 1970s. He balked at being inactive and developed an exercise regimen that kept him flexible, strong, and motivated. Later he founded the nonprofit Jimmie Heuga Center in Edwards, Colorado, to help others supplement their MS medications with exercise and an active lifestyle. So far, about 3,000 people with MS have participated in Heuga's programs in the United States and Canada.

    George Garmany, a neurologist who helps Heuga educate other MS patients about exercise, says a big benefit of staying active is that it shows MS patients that they can still live healthy lives and learn to manage their symptoms. Exercise also calms their fears of the future. Dr. Garmany says, "One of the most important things people bring home from the [Jimmie Heuga] Center's exercise program is a better understanding of their disease."


    Unpredictable Disease

    Progressive yet unpredictable, MS destroys the myelin sheath that insulates and protects nerves, thus interfering with signals the brain sends to the body. MS typically attacks a variety of areas within the central nervous system, causing symptoms that include extreme fatigue, blurred vision, numbness, lack of coordination, impaired bowel and bladder function, and many others. These symptoms can come and go, but each attack leaves plaques (scars) that may cause permanent damage. (The name multiple sclerosis means "many scars.")

    Nobody knows the cause of MS, and there is no cure, although new and more potent drugs and therapies are constantly emerging.

    The most important of these therapies so far appears to be a regular exercise routine. According to Brian Hutchinson, a physical therapist who directs the Jimmie Heuga Center, people with MS don't die from their disease: They die from heart problems, stroke, and other consequences of leading an inactive life. "If people with MS remain active and vital, they can also remain healthy," he notes. "Exercise helps them continue to have a good life."


    Mental Boost

    Charlotte Robinson, a 39-year-old Denver, Colorado, science teacher, has had MS for 10 years and remains very active. She credits exercise with giving her the mental boost she needs to face MS head-on. Robinson participated in a Jimmie Heuga Center exercise program and was so impressed that she began her own group, "Adventures Within," for people with MS who want to ski, climb, hike, and participate in other vigorous outdoor activities.

    "I'd been pretty lively all my life, and when I first started learning about this disease one of my biggest fears was that it would keep me from being active," says Robinson. "But I think exercise has actually been my salvation with MS. It was exercise that showed me I would be okay."


    Beth Israel Deaconess Medical Center. Reviewed for medical accuracy by physicians at Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School.

  2. #2
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    What I find interesting is the article on supported ambulation which says ... "the patients have to walk." Pushing a wheelchair 100 miles a day aint gonna do it. If that were the case, Rick Hansen would be fully able bodied again.

    Eric Texley

  3. #3
    BirdeR, common sense tells us that if we don't use our legs for years, the legs will not work well. Recent data suggests that non-use not only results in muscle atrophy but it may turn off neuronal circuitry. Furthermore, forced use of the circuits can result in substantial return in a significant percentage of people who have never walked after spinal cord injury. This of course does not mean that exercise alone would restore function. It just means that regeneration alone may not be effective either and that it must be regeneration, remyelination, and use of the circuits in order to maximize recovery.

    There is of course a great deal of controversy what form, how much, and how intensive the exercise should be. Too much or the wrong form of exercise may not be good. This is something that must be studied and compared. Also, it is likely that the answer is not the same for all spinal cord injuries, or MS.

    In the case of MS, many people may have stopped exercising because they were probably afraid that it might aggravate the condition through stress or cause more relapses. However, with the advent of drugs that reduce the incidence of relapses, it seems reasonable that exercise become part of the regimen that people with MS should undertake to maximize their recovery.

    Wise.

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