Regular Exercise ‘Strongly Recommended’ to Ease Fatigue in MS

Physical exercise can ease fatigue in people with multiple sclerosis (MS) and potentially benefit them in many other ways, and should be part of rehabilitation programs for patients, a large review study suggests.

The study, “The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: a systematic review and meta-analysis,” was published in the journal BMC Neurology.

Fatigue is one of the most common symptoms of MS, affecting about four in every five people with the disease. While some medications help to alleviate fatigue, non-pharmacological interventions could be beneficial as well.

Physical exercise has multiple known health benefits, such as increasing muscle strength and flexibility, the heart’s ability to pump blood, and improving a person’s mental well-being.

Several preliminary studies have also shown that physical exercise can reduce fatigue in MS patients, although recommendations for adequate and safe levels of physical activity in MS are still very limited.

A team led by researchers at Kermanshah University of Medical Sciences, in Iran, conducted a comprehensive review and meta-analysis of available scientific publications into the effects of physical activity on fatigue in MS.

A total of 31 studies, published from 1996 to 2019, assessing the effects of exercise on fatigue were included. In these trials, participants were either enrolled to a control group or to an exercise group. Types of exercises used included aerobic exercise, strength training, aquatic exercise, and rehabilitation-focused exercise regimes.

Data from the 31 studies were pooled and analyzed together. In total, data from 1,434 people — 720 in control groups and 714 in exercise groups — were analyzed.

Fatigue severity scores were a mean of 23.8 among people in the exercise group before the exercise intervention, and a mean of 16.9 after it, indicating that physical exercise reduces fatigue in patients with MS, the analysis found.

“The results of this study show that exercise significantly reduces fatigue in patients with MS,” the researchers wrote.

The team also noted that, beyond fatigue, regular exercise could have other benefits. These include “increased strength, improved body status, reduced fatigue, improved mood, increased self-esteem, and a sense of well-being,” the researchers wrote.

“Furthermore, performing the physical exercise improves one’s independence and not only improves patients’ quality of life, but also affects patients’ balance through coordinating upper and lower extremities, and prevents cardiovascular diseases, diabetes, and so on,” they added.

However, people with MS should avoid “severe” exercise so as not to provoke relapses or cause undue damage, the team stressed.

Nonetheless, “a regular exercise program is strongly recommended to be part of a rehabilitation program for these patients.”