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."