Lifting weights can improve muscle strength and quality of life for people afflicted with the degenerative disease multiple sclerosis, a new University of Florida study finds. "This is the first published report using a conventional weight-training program for patients with MS," said Lesley White, a professor in UF's department of applied physiology and kinesiology and the study's lead author. "We designed an exercise program to develop muscle strength because MS causes muscle weakness and fatigue, which contribute to a declining cycle of fitness, loss of mobility and decreased quality of life."
The study, published in the December issue of the journal Multiple Sclerosis, showed that after eight weeks of supervised resistance training on conventional gym equipment, eight MS patients had stronger muscles, could walk better, and reported less overall fatigue and disability.
The results of this preliminary study have led the National MS Society to fund an ongoing follow-up study that tracks 10 MS patients undergoing more intensive strength training for 16 weeks. The new study includes more total repetitions, thereby increasing the overall training load on the subjects, and compares the results with a control group of 10 subjects of similar age and body type. Future work will probe for mechanisms at the cellular level associated with changes in muscle strength, White said.
MS currently affects 250,000 to 350,000 people in the United States and is twice as common in women as in men, according to the National Institutes of Health. Though the cause of MS is unclear, it is thought to be an autoimmune disorder, where white blood cells attack the fatty tissue, or myelin, surrounding the nerve fibers of the central nervous system. Myelin is responsible for the transmission of nerve impulses from the brain to the muscles. MS also can lead to the destruction of the underlying nerve cells, or neurons, and their axons, or nerve endings.
The disease causes debilitating fatigue and muscle weakness, often greatly limiting physical activity and resulting in secondary effects such as obesity and depression.
MS patients also can have painfully heightened sensitivity to heat. Previous studies of the effects of aerobic exercise on MS patients showed promise, but a concurrent increase in body temperature could also exacerbate their pain. Consequently, many doctors have been hesitant to prescribe exercise regimens as treatment, thinking it could do more harm than good, White said.
Strength training, however, does not increase body temperature like aerobic exercise does, and it focuses on one of the primary targets of MS -- muscle mass. The regimen of the study included no more than 30 minutes of supervised weight training twice a week for eight weeks, focusing on the legs, abdomen and lower back. Each subject's initial weight load was determined from a pre-study strength test. Once subjects could do 15 repetitions consistently, they progressed to higher weight resistance.
"Fatigue is a huge factor for people afflicted with MS," White said. "Because no previous data on MS patients doing strength training with conventional gym equipment have been reported, we wanted to be a little conservative in our approach and therefore designed a relatively low-intensity program. But the results of this preliminary study suggest that MS patients are capable of adapting to resistance training favorably, and may be able to tolerate more intensive training."
"We're very excited," said Jennifer Lee, president of the North Florida Chapter of the National MS Society. "MS is such a complicated disease, which is why papers like this are so important. I feel like it will be our responsibility that this goes out to the doctors that we work with."
There is no cure for MS, though patients suffering an attack can take anti-inflammatory corticosteroid drugs to alleviate the duration and severity of those attacks, as well as immunosuppressants to counteract the disease. MS has been around for many years, but treatments that can effectively stop its progression have been around only since 1994, Lee said. "The course and the treatment of MS have come so far in just a short period of time."
Perhaps because of improvements in doctors' ability to recognize the symptoms, the disease is being diagnosed at an ever-younger age; often patients are in their 20s or 30s when it is identified.
"The ability to gain control over part of your disease is very important for people with MS," Lee said, "especially because it's diagnosed at such a young age. They're just starting to gain control over their lives in their 20s and 30s."
Stella Sarkees, a participant in White's pilot study, received a diagnosis of MS at age 25, when an attack left her temporarily paralyzed. "I was very scared -- immobilized and depressed. It was a depression that you cannot imagine," she said. Sarkees had been living with MS for seven years and walked with a limp when she entered the program. She currently is the organizer of Living Well with MS, a support group for MS patients in Gainesville.
The weight training was beneficial both physically and emotionally, she said. After eight weeks in the program, she noticed an improvement in her walking and was able to stop taking medication for muscle spasms.
"The benefits of exercise are so obvious, and nobody's really studied it till now," she said. "Doctors tell you, 'Don't get tired, don't work out so much, don't get fatigued.'"
Although improving muscle strength is its main benefit, Sarkees said weight training gives MS patients another advantage that's less obvious but perhaps equally important.
"You feel empowered," she said. "It keeps the focus on something instead of the depression, the illness, the situation."
From University of Florida