Can exercise reduce disease progression in MS?

Different types of exercise have been shown to improve muscle strength, quality of life, cognitive abilities, fatigue and mood in MS. But there has been very little evidence, for exercise helping to reduce brain atrophy or disease progression in MS.

In this small study published in the Multiple Sclerosis Journal, researchers in Denmark and Germany set out to investigate the effects of longer term resistance training on MRI findings, clinical measures, and patient reported measures in people with relapsing-remitting MS (RRMS).

Resistance training, which is also called strength or weight training, is a form of exercise where you voluntarily cause your skeletal muscles to “work” or contract against another force such as a heavy weight or other type of resistance such as band. It is different to aerobic, or cardio, exercise which primarily exercises your heart and lungs.

In this study, two groups of people with RRMS from Denmark, who were also taking the MS medication, interferon- beta (IFN-β), underwent supervised resistance training. The first group trained for 24 weeks, and were then allowed to continue self-guided training for a further 24 weeks. The second group did not change their lifestyle for the first 24 weeks, and then commenced supervised resistance training for the next 24 weeks. The supervised training sessions were conducted twice a week and involved upper and lower body exercises.

Both groups of people showed an improvement in the MS functional composite (MSFC) scores following the exercise training and this was maintained following the 24 weeks of self-guided training in the first group. The MSCF measures leg and arm function, as well as cognitive or thinking abilities. In contrast the standard disability measure, known as the EDSS score used by neurologists was not improved.

The Magnetic Resonance Imaging (MRI) scans identified new lesions in the brains or spinal cords of people in both groups, however the combined total volume of the lesions did not increase. In MS, existing lesions are expected to increase in size over time, which was not observed in this study. This result indicates that resistance training may cause the stabilisation or shrinkage of previously identified lesions, but does not inhibit the formation of new ones.

However, the most striking finding was found when the researchers looked at the volume of different parts of the brain. While overall brain volume did not seem to be influenced by the resistance training exercise, the researchers did note a significant change in the thickness of the outer-most part of the brain, the cortex, in some people with MS. This suggests that the exercise was having a neuroprotective or even regenerative effect on this part of the brain.

In this preliminary study, resistance training was shown to improve movement, thinking abilities, improve disability measures, and reduce the amount of brain volume lost in particular areas of the brain. However, as this study only involved 29 people with low disability scores and early in the development of their disease, these results should be viewed with that in mind.

It is often recommended that people with MS undertake regular exercise to help manage their condition and maintain physical function. These promising early results, if confirmed in larger and longer studies, suggest resistance training may also help slow the progression of MS in certain individuals.

With thanks to MS Research Australia – the lead provider of research summaries on our website.