Professor Jelinek first hypothesised that the key to optimal MS management was prevention in 1999. In an exhaustive review of the medical literature, he showed that lifestyle factors should be modified as part of a comprehensive preventive strategy to reduce the risk of progression of the illness.
Exercise as a key factor
In identifying the role of diet, sun exposure, and other factors, he drew attention to the important role of exercise in improving quality of life for PwMS.
In this newly published paper from the HOLISM series lead authored by Claudia Marck, Jelinek's team has again confirmed this initial hypothesis, demonstrating very significant improvements in quality of life for those PwMS who exercise regularly.
This study again examined this large cohort of around two and a half thousand PwMS world-wide, gathering data on their exercise habits, as well as their quality of life, relapse rate and disability, among other variables.
Quality of life
Comparing quality of life for those who exercised the most to those exercising the least, PwMS had 26% better physical health, 13% better mental health, 39% more energy, 18% better social function, and 16% better overall quality of life.
These differences are very large indeed, greater than for most other interventions ever tried in the management of this disease. Importantly, most of the benefit seemed to be derived from moving from little exercise to moderate exercise.
The investigators controlled for disability, because some might say that those with better quality of life and more energy would be more likely to exercise.
So the improvements were seen within each disability category; that is, PwMS with similar levels of disability still had much better quality of life if they exercised more frequently.
Incidentally, those with relapsing-remitting MS who exercised more also had fewer relapses. The take-home message then: regardless of level of disability, increasing the amount of exercise is associated with markedly better quality of life. And it doesn't have to be a lot! Any exercise is better than none.
► Marck CH, Hadgkiss EJ, Weiland TJ, van der Meer DM, Pereira NG, Jelinek GA. Physical activity and associated levels of disability and quality of life in people with multiple sclerosis: a large international survey. BMC Neurol 2014 Jul 12;14:143 View pdf