Symptom change with exercise is a temporary phenomenon for people with multiple sclerosis

Objective: To determine the impact of a single exercise session on function, fatigue, and sensory symptoms for people with multiple sclerosis (MS). Design: This pilot study was designed as a before-after trial. Demographic and response-to-exercise measures were taken before exercise, repeated immediately after exercise, and followed up again 24 hours later. Setting: Three metropolitan centers of an MS society. Participants: A prospective sample of 34 subjects with MS who were referred for physiotherapy for an exercise program and who could attend an MS society center. Interventions: Subjects performed an individually prescribed exercise session. which was at a commencement level and included strengthening, stretches, and fitness exercises. Subjects exercised for between 5 to 45 minutes (mean, 17.4min) at an intensity of 7 to 17 (median, 12) on the Borg rating of perceived exertion (RPE) scale. Main Outcome Measures: All outcome measures were self-rated by subjects and included the Borg RPE scale, a questionnaire for sensory symptom description, and visual analog scales for rating of fatigue, function, and intensity of sensory symptoms. Results: Subjective levels of fatigue and function immediately postexercise and 24 hours postexercise did not differ significantly from pre-exercise levels. However, over 40% of subjects experienced a temporary increase in number of sensory symptoms, 44% experienced an increase in the intensity of sensory symptoms, and 29% experienced an increase in both number and intensity immediately postexercise. Conclusions: This small study found that when people with MS undertake exercise at a commencement level, they can expect that sensory symptoms may change temporarily, but they are unlikely to have any deleterious changes in fatigue and function.