Exercise for Multiple Sclerosis

Vocabulary practice flashcards covering exercise physiology, prescription guidelines, safety considerations, and clinical testing for patients with Multiple Sclerosis (MS).

Uhthoff phenomenon

A transient ($<24\,\text{h}$) worsening of neurological symptoms, most commonly visual impairment, associated with exercise and an elevation in core body temperature.

Cardiovascular dysautonomia

Autonomic nervous system dysfunction seen in multiple sclerosis that blunts or attenuates normal heart rate and blood pressure responses during exercise, requiring the use of RPE to accurately gauge intensity.

Core temperature threshold for MS symptom exacerbation

An elevation in core body temperature by as little as $0.5\,^{\circ}\text{C}$, which can impair central nervous system nerve conduction and trigger transient symptom worsening.

ESSA Adult Pre-exercise Screening Tool

The standardized screening instrument recommended to evaluate medical history, medications, and physical symptoms prior to initiating an exercise program in individuals with multiple sclerosis.

Modified Fatigue Impact Scale

A specialized clinical instrument utilized to track, evaluate, and monitor the effects of fatigue in clients with multiple sclerosis.

Cardiorespiratory exercise prescription for MS

Aerobic conditioning performed $2-5\,\text{days/week}$ at moderate to vigorous intensity ($40\%-85\%$ of maximum heart rate or RPE $12-15$), progressing from an initial $10\,\text{min}$ bout up to $20-60\,\text{min}$.

Resistance exercise prescription for MS

Strength training performed $2$ or more non-consecutive days per week at $60\%-85\%$ of $1\text{RM}$, utilizing $1-2$ sets of $6-15$ repetitions focused on large antigravity muscles with extended rest intervals of $2-5\,\text{min}$.

Flexibility and ROM programming for MS

Static stretching exercises performed $5-7\,\text{days/week}$ ($1-2\,\text{sessions/day}$) holding stretches for $30-60\,\text{s}$ across $2-4$ repetitions to the point of slight discomfort to manage spasticity.

Low-load positional stretching

A prolonged stretching intervention lasting from several minutes to several hours used to manage significant muscle tightness and joint contractures in patients with spasticity.

Absolute red flags for exercise in MS

Contraindications requiring cessation or avoidance of exercise: acute disease relapse, core body temperature elevation of $\ge 0.5\,^{\circ}\text{C}$, acute exacerbation of neurological symptoms, and activities presenting an unmanaged fall risk.

Primary aim of exercise in MS

To maximize physical function and reduce disability or at least slow the progression of disability, while improving activities of daily living (ADLs) and overall quality of life.

Balance and mobility assessment battery for MS

A series of clinical functional tests used to determine baseline functional capacity, including the Berg Balance Scale, Timed Up and Go (TUG), chair sit-to-stand, functional reach test, tandem stance/walk, and the $10\text{-m}$ walk test.