Exercise causes temporary symptom change
 

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Arch Phys Med Rehabil. 2006 May;87(5):723-7. Related Articles, Links


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

Smith RM, Adeney-Steel M, Fulcher G, Longley WA.

Multiple Sclerosis Society of New South Wales, Sydney, Australia. rsmith@msnsw.org.au

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, 17.4 min) 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.

Thanks for the post.

This corresponds with my experience, although I'm not diagnosed with anything.

After walking (exercise), I usually have an increase or temporary episode of various sensory symptoms--Lhermitte's, itching, numbness, dizziness.

Thus, even though "outside" heat doesn't seem to bring these things on, "inside" heat does.

Nancy

I've been doing an aquatics program once a week for over a year. I always take my rolling walker to the program. After an hour of exercise in the water, my legs are so wobbly, I must rest, and have extra support to make it to the car. I find it takes my legs about 1-2 hours to recover. The rest of the week I feel so much better because I've used all of those muscles and joints that usually just hang out in a chair.

I really love the aquatics program. I've noticed a big decrease in spasticity and the ability to use my very tight ankles and feet since I started this program. Having said all of that I'm off to the pool for my weekly fun. Betty

Swimming is the only exercise that doesnt cause a pseudo exacerbation for me. The water temperature needs to be cool-ish for that to be the case.

I swim for exercise and find I'm more wobbly immediately afterwards. Yesterday I swam a 1/2 mile and when I got out of the pool I was so wobbly I staggered, fell and smashed my head on a tile wall. Ouch. Boy is my head bruised. I am going tomorrow but will get out of the pool via the steps and go directly to the chair behind it for a few minutes to regain balance a bit.

-Susan

Susan, So sorry to hear about your head injury. I'm sure I'd be on the floor beside you, if I didn't take my rolling walker to the pool side. After an hour of pool exercises even low impact, my legs are worthless and not to be trusted. It takes about 2 - 3 hours for them to come back to normal.

However I feel so much better because I move the rest of my body and joints that I'll just keep going to the pool and hope for a miracle. Betty

I went and got back on the proverbial horse this morning. I only swam 20 laps and got out of the pool on the steps sitting on the top step for a minute. Silly, but I was apprehensive. Boy do I have a bruise at the top of my thigh. Not black and blue, just black. Yuck. But I did it.

-Susan

Whoa Susan. That must have been a very bad experience!

After I swim my mile, I do notice that my legs feel heavier for about a minute or so. But Your situation sounds more intense. Good idea to just sit in the cool water for a bit while your body core cools down, and then get out.

Susan, Well it happened to me today too. I went to my aquatics program. My legs always feel like noodles when I complete the workout. I take my rolling walker and keep it at pool side to help me walk safely to the dressing room and car. I usually sit at the gym and drink some coffee to allow my legs to recover before starting the long trek to my car. Today I needed to get home quickly to meet with a contractor about redoing our bathroom to an ADA safety shower.

I was feeling good, However when I got to my car and was putting my rolling walker into the back of my station wagon, I lost my balance, fell backwards, and hit my head. Luckily no broken bones. However I do have a headache, and probably a mild concussion. Luckily there were a few people in the parking lot to help me get up.

How I hate these MS falls! I keep wondering how long I can stay lucky and not break a bone or two. I never miss taking my calcium. Trying to keep those bones strong and protected from my many falls.

I can't stay home forever. What's an MS person to do? Betty:mad:

Oh my goodness ssusan and bafriend! Those are scary incidents!

Thank goodness it wasn't worse, but still... sounds horrible. I hope you both take it easy. Sometimes even a few more minutes of exercise is too much. I find for myself that its so important to not take it to the point of total wobblyness but stop some time before that so I'm not quite so unstable after and can still function.

I hope you both heal with no long term effects.

Ouch. So sorry you fell, Betty. The physical therapist suggested I do some weighting/unweighting moves and side to side when I am getting out of pool and holding on to railing. I tried it and he's right-it did help me some in terms of regaining equilibrium. I haven't been able to swim this week due to a really really stiff neck. I'd hoped to go yesterday, but woke up unable to turn my head again. Maybe tomorrow. I have cut down from 1/2 mile to 25 laps so I am a little more stable upon getting out.

Glad you didn't break anything. It took about 10 days for my head to feel normal after concussion. Sorry to hear you fell.

-Susan

Regardless of what you do for exercise you need to give your body time relax before moving on. Getting your exercise in a pool will help with keeping your body temp down. However, you could still have a problem with weakness, balance, sensory type symptoms, or whatever symptoms you have with your MS.

Try sitting at the edge of the pool for a bit to let things get back to normal before standing. After you have gotten dressed and if there is a chair, couch ect. out in the lobby sit out there for a little bit to make sure you feel stable.

You cannot or at least it's not a good idea to be in a hurry after you have exercised....bad things happen when in a hurry and you have MS.

Bafriend and Ssuan I hope both of you are doing better.

Exercise
 

I used to look like I was drunk when I would walk away from my exercise class. That's when I got my "I have MS" card from the Rocky Mountain MS Center. It says:

(My name and address and emergency contact)

The person named on this card has multiple sclerosis and may have any or all of the following symptoms:Loss of balance or coordination
Difficulty walking or writing
Numbness or partial paralysis
Double or blurred vision
Slurred speach
Extreme fatigue

Snoopy, excellent advise. I promised myself that I will always have the time to sit and equilibrate after my aquatics program or I won't go. I notice these untimely falls always occur during a time I'm feeling really good and think I have this disease under control.

Susan, Are you doing these weighting/unweighted moves and side to side moves on land or in the water? I really wish I could still swim. Swimming really gives me severe leg cramps. The aquatics program is much easier for me. When I first started I did have some cramping of my feet, however that's much better and my foot flexion has really improved after more than a year of this program.

Today I'm staying home and doing nothing. I want to make sure this concussion is under control. I had some prednisone which I promptly took to lessen the symptoms of headache and probable concussion. Plan to taper it off over the next 3 days. My head feels almost normal today. You might want to consider a couple days of prednisone for your stiff neck.

MS always offers us a new surprise and reminder that we are not cured. After a fall like yesterday, it's sure hard to stay optimistic. However I'll be back at the pool in a couple of days as the aquatics has helped me more than any other therapy I've done. Betty

I don't usually think I have this disease under control....well, at least most of the time:rolleyes:

I understand the *feeling really great* part, that's also when I fall or get hurt. It's almost like a natural high, I feel really good and seem to have alot of energy and I'm happy to the point of being *giddy*

It's at those times I get careless. I have learned to slow myself down when I feel like that but I really have to focus on doing that.

Goodness! Sorry to hear about your falls. Hope you mend quickly.

I had one bad year where I fell five times rollerblading. The fifth fall meant an ambulance and a miserable year and a half in physio.

I know exercise is supposed to make you feel better. Since I don't have a dx and over the years my doctors told said I was imagining things, I would push and push myself to exercise only to feel horrible afterwards. I can honestly say exercise does not make me feel better.

Snoopy: I understand about the "slowing down part", when one feels good it's too easy to think we are normal again. My head is in my twenties, my body isn't and when I fall, I don't bounce. :) I keep having to remind myself to walk carefully.

Cricket,

Don't push your exercise. With or without a diagnosis you need to take exercise slowly and work under what your capable of. If your falling on rollerblades DON'T use them;)

No pain, no gain IS NOT the way to approach exercise. It's also very important to cool down afterwards, especially if your heat sensitive. I always take a cool shower after exercise - not only do I smell better afterwards but it helps me recoup my energy:).

Cool Shower !!!! Why didn't I think of that.

I actually go to a warm water pool for my aquatics class. It's never very hot and I have no problems with the exercises. I just don't linger in the pool when class is over. Last year I exercised in a regular temp pool and had the same problems with muscle fatigue post exercise. I actually enjoy the class more in the warmer water.

I'll keep going to the class because once my legs recover from the exercises, I always feel so much better, it's such a help to stretch out the other muscles in my mostly sitting body. Snoopy thanx for the tip. Betty

Hi Betty,
I am doing those wighting/ unweighting beginning on the stairs in the water (holding onto the railing) and then out of the water touching the wall for balance. I am hoping to go swimming in the morning. This stiff neck is still hanging around. Think I'll try at least a few laps. The day I fell and the next I stayed really quiet. I just didn't feel right. Hope you're feeling better.

-Susan