Expert Insights – Physical Activity

04:12 The definition of physical activity and exercise

06:24 How the body works

08:08 Myokines

10:00 Professor Robert Motl

15:13 Disease modifying intervention

17:04 Resistance training and myokine production

17:45 Aerobic training and MS

20:32 Stretching and its benefits

23:02 Physical activity and improving MS symptoms 

24:35 Overcoming MS’s physical activity recommendations

28:33 Dr Gretchen Hawley’s 6 out of 10

31:26 Introduction to Lyndsey Housden

38:51 Physical activity practice

45:03 Important exercises for people living with Primary Progressive MS

48:59 Aids for balance training 

50:53 How much is too much?

55:16 Exercises for managing fatigue and spasticity

57:17 Assistive devices for supporting exercising 

58:31 Free, at-home exercise programmes

59:58 Choosing a physiotherapist

1:02:20 What is HIIT?

1:08:51 Exercise and mental health

1:18:00 Upcoming events at Overcoming MS

 

Heather O’Neil

Heather is a Clinical Social Worker and has been working with individuals and couples in private practice and other organisations for the past 27 years. She specialises in treating trauma, coping with chronic illness and anxiety disorders.

She was diagnosed with MS in 2020 and found the Overcoming MS program very shortly into her diagnosis. It has given her a tremendous amount of agency over her own health and has allowed her to manage her anxiety related to this illness. Overall, Heather feels healthier and more connected to her body.

Heather lives in Denver, Colorado in the U.S. and enjoys spending time with family and friends.  She loves skiing, hiking and travelling.  When not out adventuring she can be found curled up with a good book. Heather is married and has two young adult children and a dog.

Lyndsey Housden

Lyndsey has a background spanning health and wellbeing coaching, academic coaching and teaching in the creative arts and design. After being diagnosed with MS in 2010, whilst living in the Netherlands, she discovered the Overcoming MS Program, which inspired her to pivot her work toward coaching and supporting others on their own health and wellbeing journeys.

Lyndsey brings a holistic approach to helping others thrive. As a qualified health and wellbeing coach and academic coach, Lyndsey works with individuals and groups, to support personal growth, resilience, and sustainable wellbeing – both in life and learning.

Lyndsey teaches accessible yoga, with a focus on inclusivity and adapting movement to suit all bodies. Lyndsey is also an artist and creative producer, which continues to shape her approach, encouraging creativity, connection, and empowerment in every aspect of her work.

Heather O’Neil (00:07.106)

Hi everyone. And welcome back to Living Well with MS Webinar Series, Season Six. So we’re really pleased to bring you tonight’s session where we’re going to be discussing and deep diving into the topic of physical activity in MS. We’re going to be bringing to life the Overcoming MS Program with the help of expert program facilitators and community members.

 

So my name is Heather O’Neil. I’m an Overcoming MS Facilitator and Clinical Social Worker joining you from Denver, Colorado in the United States. And in today’s webinar, as well as discussing physical activity in MS, we’re going to be joined by a community member and trainee program facilitator, Lyndsey Housden, who’s going to be sharing her experience with physical activity pillar and helping me answer some of your questions in the Q&A later on.

 

Before we get started, I just want to go through a bit of housekeeping to help us keep that webinar running smoothly as possible for you. So you’re going to notice that the session is being recorded and you will receive a link via Zoom to access that recording next week. Because this is a Zoom webinar, you will only be able to see the guest speakers. However, it’s still interactive as you will be able to ask questions using the Q &A tab on your screen.

 

So please do submit your questions. We know we have some that have been submitted early as well. And please note that our expert guest speakers cannot comment or advise on any individual circumstances. So try to keep your questions generalized so that everyone can benefit. We’ve scheduled 90 minutes for today as a webinar. And so we’re going to do our best to answer all your questions that we receive. Well, we receive a lot of those, so don’t be disheartened if we can’t get to all of them.

 

If you experience any technical problems during the webinar, try exiting the browser and re-entering using the link in your email. We do recommend using a Chrome browser to access today’s webinar. It seems to work better. We’ve tried to make the webinar session as accessible as possible. So today we’re going to be using subtitles, which you can see at the bottom of your screen. You can turn these on and off by clicking the CC live transcript option.

 

Heather O’Neil (02:25.998)

And as you exit the webinar, you’re gonna see a short survey pop up automatically. And we’d really love and appreciate it if you could fill that out. It helps give us information. It helps us shape future webinars and events going forward. So with all of that said, let’s dive in to physical activity, right? So I’m gonna share my screen with you guys. Let me get out of here.

 

Heather O’Neil (02:56.79)

is always there.

 

Heather O’Neil (03:13.685)

All right, so hopefully.

 

You guys can all see that.

 

Heather O’Neil (03:25.08)

So obviously, Living Well with MS webinar series, physical activity. Yeah, I got some thumbs up. Great. So let’s go ahead. Before we dive into this specific around physical activity, I want to just highlight the Overcoming MS Program in general. We’ve got these different seven pillars. We’ve got diet and nutrition. We’ve got sun and vitamin D. We’ve got physical activity. We’ve got stress management.

 

We’ve got medication, if you and your doctor choose that, we’ve got family health and change your life for life. So obviously this is kind of that whole Program and we’re gonna deep dive today into physical activity. And before we go any further, I just wanna like highlight a little bit of a definition. So physical activity and exercise, we’re gonna kind of be using those interchangeable today, but they’re actually two different definitions. So physical activity is anything that gets

 

your heart rate above resting, right? So walking up and down the stairs, gardening, doing the dishes, things like that. Exercise on the other hand is really a planned, structured, repetitive movement with a fitness goal in mind. So we’re gonna kind of be talking about both of those, but know that there’s a little bit of nuanced difference with the two. So.

 

Just a basic overview of what this is gonna look like today, of what we’re gonna be covering. We’re gonna look at the general benefits of physical activity. We’re gonna be looking at physical activity and brain health. We’re gonna look at the recommendations and guidelines from the Overcoming MS program of kind of, what do I do, right? What are, you know, what’s the logistics, right? Let’s get down to what we should be doing. Lindsay is gonna talk about her story and share a little bit about physical activity.

 

We’re gonna have a stretch break and then we’re gonna get to the Q &A section today. So all of that, we’re gonna try to be timely in this 90 minutes. And so I’m gonna go ahead and dive into the material. So let’s just start, we’re gonna start with this quote by Kelly McGonigal. It’s just talks, physical activity influences many brain chemicals, including those that give you energy, alleviate worry and help you bond with others.

 

Heather O’Neil (05:41.28)

It reduces inflammation in the brain. The mind altering effects of exercise are even embedded in your musculature. So I’m hoping today as we go through this information that you’re gonna get really excited. Maybe some of you on this webinar already do a lot of exercise. Maybe some of you aren’t doing as much as you know you should and I’m hoping.

 

that we leave you with a lot of excitement about the why. Like there’s a lot of great science and research around how it impacts our body and how it impacts our brain. And so I’m really hoping that that’s what you take away today is excitement and really kind of a love of like, okay, I wanna move forward and I wanna do this part of the program.

 

So we start with just kind of how the body works, right? And homeostasis is this constant tweaking to keep us safe and alive. And we tend to think of the body as different organ systems, right? Cardiovascular over there, digestive over there, skeletal over there, as if they were kind of separate things. But in reality, these systems all work together and they work together to create homeostasis, right? To get us, to keep us alive and safe.

 

A good example of this is eating. So eating isn’t just the digestive system, right? It involves the muscular system to contract and move the food through the esophagus and stomach. It involves the respiratory system, which stores energy from the food. The circulatory system transports nutrients to different organs. And then the digestive system breaks down the food so the body can absorb it. So, so many different systems are involved.

 

And these systems communicate via the autonomic nervous system, right? These are the things that are going on that we don’t have to think about like breathing, right? We don’t have to think about breathing. It’s just happening, right? To keep us safe and alive. And they also communicate through the endocrine system and the skeletal muscle is an endocrine organ. And this matters because it means that when, it means that muscles can communicate with the rest of the body.

 

Heather O’Neil (07:44.876)

And it’s really why when you exercise, you can improve functioning in all the other organ systems. So as we talked today about specifically physical activity and exercise, which is helpful for everybody, it’s particularly helpful for people with MS so that our systems and organs are running more smoothly and working together.

 

Heather O’Neil (08:08.652)

So with exercise and physical activity, our muscles contract and this produces myokines. And myokines are molecules that are exchanged between the muscles to the brain and other organs and systems. And right now researchers know about 650 of these different myokines, right? We’re learning new things all along and these different myokines do different things. A few of them that are particular to people with MS,

 

is they do things like regulate heat and body temperature and weight loss. They help reduce inflammation. They help with survival and growth of neurons. They help with neuroplasticity, right? So these are things that are particularly important. And they also have an anti-inflammatory impact on our body, which is also important as MS is an inflammatory disease.

 

Heather O’Neil (09:04.268)

So besides physical activity, there’s other factors that influence myokin production. A few of those, body weight management, being a regular body weight, stress reduction, nutrition, daily movement, and other lifestyle factors. And I just want to have you pause for a minute and think back to that circle we started with about the overall Overcoming MS program, and think about how all of these things really line up with what we’re doing

 

as a totality in overcoming MS program. So we’re influencing myokin production by all of these things we’re doing. The other bullet point on there is an unhealthy lifestyle leads to loss of muscle mass and impaired myokin production. So if you don’t use it, you lose it. This idea of keeping track of that as well.

 

Heather O’Neil (10:02.094)

So this next slide is really, it was a presentation done by Professor Robert Model, who’s a researcher, a well-known researcher around exercise, physical activity, and MS in the States. And he really talks about this idea of all the systems working together better with exercise, right? And in this presentation, he talked about physical activity activates the central nervous system, the peripheral nervous system, the endocrine system.

 

the skeletal muscle system and the cardiovascular system. And he goes on to say, it does so in a very integrative and systematic manner and by repeatedly exposing yourself to bouts of exercise. All of these systems adapt in an integrative manner. They learn how to work better, they grow stronger and they grow better. So we’ve got all of this.

 

great research that’s coming around around the physical body and how it helps and how exercise and physical activity help people specifically living with MS. We also have great information about how physical activity and exercise also influence the brain. So Dr. Wendy Suzuki is a professor of neuroscience and psychology. And if you’re interested in her work, she’s got a great Ted talk that you can kind of check out. But

 

This quote is just simply moving your body has immediate, long lasting and protective benefits for your brain. And that can last for the rest of your life. Her research really kind of looks at two specific areas in the brain that are influenced and benefit from physical activity. One is the prefrontal cortex, which is critical for decision-making, focus, attention and personality. And I like to think about

 

when we think about symptoms of MS, we think about like that cog fog or that inability to focus. And so that prefrontal cortex with physical activity improves. The hippocampus also improves, which is critical for our ability to form and retain your long-term memories for facts and events. And I think about this with cognition, right? As…

 

Heather O’Neil (12:13.938)

MS is a degenerative disease, right, a neurodegenerative disease, and so cognition sometimes is problematic. And so by doing physical activity and by doing exercise, we know we’re improving these two areas. So there’s also Dr. Model in some recent research I was going through as I was getting ready for this webinar. I came across a paper that he published looking also at how exercise impacted the thalamus.

 

which is a major relay area associated with cognition and the basal ganglia, which is associated with movement and control of movement in a smooth and coordinated way. And his research really showed that as aerobic fitness gets higher, the volume and integrity of these structures in the brain get better. So there’s a lot of great information about the brain and physical activity.

 

And with physical activity, right, our brains can strengthen and they can find new neural pathways. Strong neural pathways equal stronger muscles and improved mobility. I love this next bullet point. I think we should just kind of highlight this. So neuroplasticity can happen for anyone with MS regardless of the level of disability or the year of diagnosis.

 

So if you’re on this webinar today and you’re thinking, but I have a lot of disabilities, so don’t know if this applies to me, it absolutely applies to you, right? Because neuroplasticity can happen for anyone with MS, regardless of level, disability, or your diagnosis. So hopefully if you take anything today, that’s a really good one to kind of stick in your brain and walk away with. This next bullet point on there really gets to the idea of visualization.

 

So give your brain a chance to find new neural pathways by repeating the exercise, even with no movement. So we know this with sports psychology, right? We work with athletes around kind of visualizing the next event, Visualizing their race or visualizing the game, because as they go over and over their head and visualizing that they are creating new neural pathways, we too can do that.

 

Heather O’Neil (14:26.188)

with, you without being an athlete, right? So let’s say you have some weakness in one of your arms and you can only do a few bicep curls, right? And then it just, you know, feels like, okay, I can’t do any more than that. But you can work with visualization of actually visualizing that movement because we know that creates new neural pathways and will enforce kind of getting stronger.

 

Heather O’Neil (14:51.768)

So we’ve got all this great information, right? And now we want to talk about, so, okay, what are some of the specifics, right? We know exercise is good for the body. We know exercise is good for the brain. What kind of exercise should we be doing?

 

The other thing I wanna talk about before we get on to kind of what we should be doing is this idea of a disease modifying intervention. So Professor Dallgus is another researcher who does a lot with exercise and MS and he is out of Europe. And he really is asking this question more and more, I think all of us are asking this question more and more, is this a disease modifying intervention? And he talks about exercise is a safe and well-recognized symptomatic treatment.

 

option that has beneficial effects on a variety of symptoms in persons with MS. And we know we’ve got a lot of, we’ve got a big body of research that shares that exercise can help with symptoms of MS. And we’re going to talk about some of those symptoms a little bit later on. But, which is great to know because, you know, 20 plus years ago, people were told not to exercise, not to do physical activity if they had MS. And we know that that is absolutely not true now. We know that exercise and physical activity needs to be a part

 

of the protocol with this disease. He also shares, however, recent evidence suggests that exercise may also have a disease modifying effect in persons with MS and may even have a preventative effect by lowering the disease risk. So we’re getting more and more information, getting closer to being able to really identify this as a disease modifying intervention physical activity. In a paper I read recently with him too, he also talks about

 

Really this idea of can we start encouraging neurologists to prescribe exercise and physical activity to people with MS. That is how much research we are getting on how helpful this can be for our disease progression.

 

Heather O’Neil (16:49.87)

Okay, and now we’re gonna get it to this resistance. So we wanna start with like, so what do we do, right? So we know this is all good for us, so how do we do it? So we know we need to be doing some resistance training. So resistance training really increases myocaine production. And this slide is really busy. And I think the goal of this slide is to, you see weightlifting over there. And when we think about resistance training, I think we often think about weightlifting. But there are other resistance training ideas too, right?

 

rock climbing, boxing, rowing. So, and the best exercise you can do as we talk about these next few things is the exercise that you enjoy doing. So if you are trying to do something that you’re not enjoying, it’s unlikely that you’re going to be consistent with it. And consistency is really the name of the game in exercise and physical activity. So we know we need to be doing some resistance training.

 

we know we need to be doing some aerobic training, getting our heart rate up, right? And on the left-hand side there, you see people with MS, and this is a generalization, but people with MS tend to have significant lower VO2 max. So VO2 max is an indication of how well you use oxygen. It really tells us about our aerobic fitness. So some of us have these fancy watches. I have a little Apple watch.

 

And that tells me my VO2 max, I don’t know how accurate it is, but it’s certainly more accurate than me guessing. If you don’t have a fancy watch, you can ask your doctor, right? And if you’re into kind of numbers and things like that, great. But just know that it’s kind of, yeah, it tells us our aerobic fitness. And people with MS in general have lower VO2 max, and it also gets lower with age.

 

A recent journal article I read from Dr. Model explained that it isn’t so much something inherent with the disease of MS that makes people have a lower aerobic fitness. It’s really that people with MS tend to do less exercise and physical activity. He even cited a study that showed that 20 % of adults with MS in the US, only 20 % of adults in the US engage in recommended amounts of

 

Heather O’Neil (19:07.016)

of exercise and physical activity for health. So that means 80 % are not doing the recommended daily amount. And so that’s why we’re here today really talking about how do we get more physical activity and exercise into your life. Other things, people with MS tend to have a lower six minute walk test results. We tend to have impaired heart rate reserve.

 

So heart rate reserve is really the difference between your maximum heart rate when you’re working out at maximum level and your resting heart rate. And people with MS tend to have widespread pattern of gray matter atrophy. The research that, and what research really shows is that by doing physical activity, by doing aerobic training specifically, it really modifies

 

the gray matter areas, especially involved in sensory motor control, visual processing, and cognitive functions, right? Which are all very significant for people living with MS. It also has neuroprotective role with reduced atrophy progression rate. So we need to be doing some resistance training. We need to be doing some aerobic training, getting our heart rate up. We also need to be doing some stretching.

 

So stretching helps to release endorphins, dopamine and serotonin, which help to motivate us, fight off depression and decrease anxiety. Dr. Helen Langvins has done some work around yoga rats and so, it’s a yoga rats experiment is what it’s called. And so basically they took a group of rats and they injected them with an inflammatory chemical, right? So they had inflammation in their rat bodies, right? Half of the group,

 

was given stretches. So half the group was giving these yoga stretches where the rats held on and they pulled up their tail like they were doing downward dog. And half of the group was not given that. And what they found was the rats that were stretched had a high concentration of resolvins in the tissues after stretching, which turns off inflammation. The other thing they found that was really cool was that resolvins enter the blood and make clear inflammation anywhere in the body. So if you might be stretching your arms, but you’re having

 

Heather O’Neil (21:28.512)

an anti-inflammatory effect in the whole body. So we need to be doing some resistance training. We need to be doing some aerobic training and we need to be doing some stretching.

 

The Wholism study, which has been going on since 2011 with about 2,500 participants, and the results really show that exercise was associated with less disability, better quality of life, and lower risk of depression. And exercise, it also showed that exercise has protective effects, helps to manage symptoms, preserves brain volume, and has disease-modifying benefits, right? All of these things.

 

to get us excited about why am I here doing this, right? How do I get over some of the barriers for not being able to do it? And this graph here in the yellow, it really shows people who are doing very little physical activity. The blue shows people doing moderate activity and the light blue is people who are doing a lot of physical activity. And one of the things I want you to notice is that really the biggest jump is from people doing very little.

 

to doing moderate activity. So we don’t have to be Olympic athletes. As we increase physical activity and exercise, we are getting benefits with energy, with social functioning, with overall quality of life, with physical health and with mental health.

 

Heather O’Neil (23:00.59)

So we know we talked a couple of slides ago about this idea of what symptoms does exercise and physical activity help us with? And so I wanna just highlight these because there’s a lot of them. So physical activity helps increase muscle strength. It improves walking speed, which we mentioned a few slides ago, which is lower with people with MS.

 

It increases energy levels. And I love this one because I think one of the biggest barriers of people not doing physical activity with MS is often fatigue. And what we know is that exercise actually improves fatigue. It’s not a one-on-one. It’s not like I exercise or I work, I do physical activity today and tomorrow my fatigue is better. But what you will notice as you increase and do more physical activity and exercise,

 

the evidence really shows that fatigue decreases. It improves mood. It reduces relapse rate, improves sexual function, improves bowel and bladder function, lowers the risk of depression, offers better quality of life, and is associated with less disability. So we’ve got a lot of things specific to people with MS.

 

where exercise and physical activity are really significantly helpful.

 

Heather O’Neil (24:24.91)

So we get to that place where people start asking, okay, so I know I need to be doing resistance training. I know I need to be doing aerobic training and I need to be doing some stretching, but what are the specifics to that, right? So how often is two to three days per week to start and you’re building up to two to five days per week and you’re gradually increasing to 30 minutes.

 

So the amount of time for physical activity and exercise that is recommended is actually not different from people without MS. It’s 150 minutes of moderate exercise a week. Same for people with MS as people without MS. The how hard question, this idea of moderate intensity. So moderate intensity, some of us have these fancy watches that will give us kind of what we’re exercising at.

 

but also know that moderate intensity can just be done with a breath test. if you can, so moderate intensity is basically you can talk, but you probably can’t have a full conversation and you can’t sing. And so if you can have a full conversation and it’s not really a problem, you’re probably going too slow. And if you can only utter a few words, you’re probably going too fast. So it’s somewhere in the middle of there, that moderate intensity.

 

And the note on the bottom, it says including strengthening. I would also say including stretching, right? We want all of that, right? We want resistance training, we want aerobic training, and we want stretching. Increased repetitions and intensity as the body adapts. So our bodies will adapt to exercise, and that’s when we have to either increase intensity or we have to increase repetitions, right? Or we have to go.

 

longer. So, you know, as your body adapts, then you change things around. This other thing is start slow and build over time.

 

Heather O’Neil (26:27.832)

So it’s not a one size fits all, right? If you’re not doing any physical activity, you might want to start with five minutes in total and slowly build up to 30 minutes, maybe start with two sessions a week and focus on moving more, just getting more physical activity in your day-to-day life. If you already have a routine, you want to build up to 30 minutes per session, maybe build up from two to five sessions per week.

 

and including strengthening as well as aerobic exercise. And I would also include some stretching in there. You wanna prioritize safety. So one of the things I would say is if you are not doing a lot of physical activity, probably talking with your physician first to make sure you get cleared to start an exercise regime would be really helpful. And prioritize safety, right? Use assisted devices if balance is an issue. You can use the pool.

 

if heat is an issue. So there are ways to adapt things for your safety. Don’t overdo it. This is always a hard one, right? What is overdoing it? That’s a really personal one and I can’t tell you what overdoing it is for you. I think this is where it’s really helpful also to think about the circles, right? Because in that stress management, right? We’ve got meditation and mindfulness practices.

 

And I think it’s really helpful here in exercise because when we can tune into our body, we start to listen to like and know a little bit more about what’s too much and what’s not enough. And the more you get comfortable with that, the easier you’ll be able to know and like, okay, absolutely overdid it. I need to kind of scale back a little bit. And then the final thing on there, talks about focus on regularity and progression. So consistency, right?

 

This is not like, I do this once and then I don’t work out or I don’t do any exercise for a month. It’s doing something consistently over time is how you’re going to see the benefits of this.

 

Heather O’Neil (28:31.662)

So Dr. Gretchen Halle from the MSing link, she talks about this idea of six out of 10. And I love this idea. know, we think about the diet, we talk about eating, you guys have probably heard eating the colors of the rainbow. And this is kind of the exercise and the physical activity version of that, of trying to get six out of 10 of these. So, you know, looking at strength, endurance, stretching, balance, aerobic exercise.

 

I’m sure for some of you on this webinar, you’re kind of like, my gosh, this is overwhelming. How would I possibly get six out of 10 of these? And I just want to throw out a couple of examples because it’s actually easier than you think. So let’s just take an example of if you took a yoga class. So if you took a yoga class, you’re going to get some stretching, some balance, some coordination. You’re going to be implementing daily movement. And if you actually go to a class, you’re going to get

 

Five of these already just in a yoga class, right? I’ll throw out another example, right? Let’s talk about if you’re a walker, like you do, that’s the physical activity you like to do, you like to go on a walk. So if you do walking and let’s say you’re like, okay, I wanna add some things in here. I’m gonna do some speed work. So I’m gonna walk my normal pace and then maybe for 30 seconds or a minute, I’m gonna increase my walking speed for a little bit and then I’m gonna come back to that regular speed and I’m gonna do that throughout my 30 minutes of my walk, right?

 

So you’re gonna get some strengthening from the walking. You’re gonna get some endurance. You’re gonna get some aerobic exercise, because you’re gonna get that heart rate up. You’re gonna get some speed work. And you’re going to get some implementing daily movement. So again, trying to get six out of 10 of these. I think the other thing where I think this is really helpful is for some of you on this webinar, you’re already doing a lot of exercise. You’re like, okay.

 

This is just reinforcing what I’m already doing. This is a really good place to come back to for those of you who are doing that. So you might be doing a lot of physical activity, but are you doing all of these things? And can you incorporate some of these? And so this is a nice way to kind of add some things in if you’re one of those people who are already doing a lot.

 

Heather O’Neil (30:49.942)

And so just this idea of making time for movement in your life is not a luxury and it’s not self-indulgent, it’s a necessity. And so I would like all of you guys, as you kind of take in, I know it’s a lot of information and a short bit of time to think about that, but taking that in today and we’re gonna kind of shift gears a little bit because I’m gonna invite Lindsay to share her story with you.

 

And then we’re gonna do a short stretch bake and go from there. But Lindsay, if you wanna introduce yourself.

 

Yeah, thanks, Heather. Hi, everyone. So yeah, as Heather said, I’m Lindsay Houston, and I’m on this journey of becoming a trainee facilitator, or am a trainee facilitator at the moment. I’m, yeah, on this journey to begin to share this information. So I’ll just share a bit about my journey with MS. And I was diagnosed first of all, when I was living in the Netherlands when I was 30.

 

and it was around about 2010. And, you know, I think at the time is you may also if you’ve had a chance to speak to other people with MS, you might notice some similarities in the timing of your diagnosis that there may be a significant life event that happens around about that time. So increased stress levels.

 

The Netherlands is not particularly known for its sunny environment, so probably some low vitamin D levels, and it’s got a very high dairy content in the diet. So anyway, not to blame the Netherlands, but yeah, that was my experience in 2010. I was diagnosed whilst living by myself in a country without my family around. So of course, some isolation there as well, and all of those things.

 

Lyndsey Housden (32:48.054)

Yeah, it was great and wonderful to find the OMS programme and one of the big kind of light and encouraging aspects to it was the community that is also there and the people that I’ve been able to meet since then. So in the context of the physical health and exercise pillar of the OMS programme, I would say that at the time of

 

experiencing the diagnosis that was probably becoming quite disconnected from my body. I wasn’t exercising very much. And, you know, in that way that when you are stressed, you stop to take care of yourself as well as you would do normally. And I think one thing that I found with yoga became quite a big part of my life, I would say, and still is something that I absolutely love doing.

 

More so than some of the other exercise that I was doing. You know how it is when you go through the diagnosis process, you’re suddenly in a hospital, you’re being scanned and it’s all kind of data and technical conversations. And then when I shared my diagnosis with a yoga teacher that I was seeing at the time, he just actually said, we’re going to get through this. He was 72, he was teaching five classes of yoga a day.

 

And well, talk about consistency, he definitely lived what he taught. So having somebody there to support me in that journey and especially to begin to reconnect with myself again. I yoga is wonderful in that it has, it helps you to develop, to train and develop your breathing so that you are able to regulate actually what it’s doing is regulating your

 

your nervous system, so it’s helping you to come into a more the relaxed part of your nervous system or the parasympathetic part of your nervous system. So, so you’re doing those stretching where you’re also releasing, of course, the anti-inflammatory molecules. You’re also developing strength and you’re also developing a kind of proprioception and an inner awareness of what you need and what you need to take care of yourself. And I think it was that.

 

Lyndsey Housden (35:15.114)

development and understanding that really helped me to make some good decisions regarding my health. so, yeah, that was a kind of major part of my journey, I say. And since then, I’ve developed, become a yoga teacher myself, and also like to share my practice and also work towards chair yoga and assisted yoga practices as well.

 

Yeah, so I think that’s really my journey with MS and certainly since connecting with the OMS community, I think back in 2015. So it took me about five years to find OMS. It was actually through this book, the Overcoming MS Handbook. Well, the original, the first version actually, I highly recommend getting a copy. It’s quite dense, it’s full of…

 

lots of practical and scientific and research and evidence-based research. So it’s really great one to sort of look through and also look at other people’s experiences. So when I found them and I joined the retreat recently, well twice now, it was the first time that I’d met other people with MS. When I was initially diagnosed, the advice in a way was,

 

Maybe it’s best not to meet other people with MS. You might become worried. Well, I’ve got a chronic disease that is completely, you can’t make any predictions about it. What’s more to be worried about? Let’s just meet people and exchange. So that’s what I really loved about the MS community is the first time that you could really let your guard drop and you could really share your experiences and

 

hear how people build in exercise during the week, how they deal with fatigue, how they deal with disclosure of their condition to their workplace, how they deal with adapting their life as the disease changes or takes different progression. So yeah, it’s been a wonderful journey to become part of this community and to learn more about

 

Lyndsey Housden (37:36.11)

certainly the more the research and the evidence around the programme which keeps becoming deeper and deeper. So thank you. That’s my journey. Hello. I would love to hand back over to you. It’s also my first webinar so used to speaking to with more interaction. yeah. I’ll be back for the Q &A a bit later. thanks for the heart.

 

Thanks, Lindsay.

 

Heather O’Neil (38:03.598)

So we’re going to do, because this is, we’re talking about physical activity, we’re going to do a little stretch break. And I heard a recent thing and it was called exercise snacks. And I love this idea. So we’re going to do a little exercise snack, right? A little short thing. So if you are able to stand up and kind of wiggle things out and shake things out, great. If you’re not, you can just stay seated, whatever your mobility is, right? And if you, as we do this today, if any of this doesn’t

 

feel like you can actually do it because of mobility, I would say this is a good time to practice visualization. Close your eyes and visualize doing it without any movement at all. So let’s start by just, if you can, my office is kind of small, so I’m gonna try to stay on the screen if I can, but you might lose me a little bit. So we’re just gonna stand up and kind of shake out the body, shake out the neck, do some wiggles.

 

Heather O’Neil (38:59.734)

And then going ahead and sitting back down. And just hand on heart and closing your eyes. I think I mentioned before this idea of bringing some mindfulness into exercise is really helpful because we begin to notice our bodies. So just closing your eyes and just taking a moment to tune in with what’s happening with your body today. Not making judgment, right? We come at it from curiosity instead of judgment. Being curious.

 

And then going ahead and opening your eyes. And we’re going to start with this thing called the breath of joy is what it’s often called and what it looks like. And then we’ll all do it together is you’re going to inhale for a third of the breath, another third of the breath and a third of the breath and then so all together, right?

 

Heather O’Neil (39:52.395)

a couple more.

 

Heather O’Neil (40:01.55)

I’m just kind of noticing how that feels in the body.

 

We’re gonna inhale the arms up. And as you exhale, we’re gonna twist to the right. And you’re just twisting over to the right, looking out over your shoulder, breathing here. You’re gonna imagine you have a string at the top of your head and it’s just lifting your spine up towards the ceiling.

 

Heather O’Neil (40:27.662)

And exhaling, coming back to center, inhaling the arms up. You can look up if you’d like, and exhale, twisting to the left. So right hand comes onto your leg or the chair.

 

Heather O’Neil (40:45.674)

and then inhaling back to center. We’re gonna inhale those arms up over your head, sneak back here. You’re gonna take your right hand on your left wrist and you’re just gonna reach over to the right. You can look up towards the ceiling, you can look in the center and you’re just breathing here.

 

Heather O’Neil (41:10.312)

inhaling up to center, stretching up, getting the body long, exhaling over to the left.

 

Heather O’Neil (41:21.706)

And then going ahead and coming back to center, you can bring those shoulders up towards the ears and roll them back and down, maybe just a few times in one direction and then the other.

 

Heather O’Neil (41:39.848)

shaking it out. Last thing we’re going to do is just a real quick seated cat-cow. So the hands are going to come onto your knees and you’re inhaling. You’re going to imagine that there’s a string at your chest and it’s just lifting you up towards the ceiling. And as you exhale, you’re rounding your spine like a Halloween cat. Inhaling up.

 

exhaling down.

 

Heather O’Neil (42:06.806)

and two more times inhaling up.

 

exhaling down.

 

And last time in healing up.

 

Exhaling, rounding the spine.

 

Heather O’Neil (42:24.654)

And just coming back to center in the same place we started with, I want you just to take your hand on your heart and close your eyes for a moment and just tune in with your body. Just noticing kind of what feels different. Again, coming at this from curiosity, not judgment. So not kind of judging your body or what feels good or what doesn’t feel good. Just like, that’s interesting, right? That changed.

 

Heather O’Neil (42:52.406)

And then going ahead and simply opening your eyes.

 

Heather O’Neil (42:59.246)

So we’re gonna move into the Q &A portion of this, because we wanna have enough time to get to all of your great questions. So Lindsay and I are both gonna be on board. And let’s see, I’m gonna try to pull this up.

 

Heather O’Neil (43:26.584)

So going ahead.

 

Heather O’Neil (43:31.15)

I’m gonna go ahead and read out loud the first question and answer it. So the question that was submitted was I have checked out a number of programs like the MS workout and the MS needs link to see if there’s something I can do or should be doing to prevent progression. I work out five to six days a week and do HIIT, which is high intensity interval training for those of you who don’t know yoga and hiking. Is there anything I can add to my

 

current routine that would be helpful. So first and foremost, I would just say congratulations, right? You are doing a lot of physical activity and exercise. You’re really hitting those numbers, right? That we talked about today. The only thing that I would say, and again, I don’t know what exactly you’re doing, but maybe possibly adding some strength in there and maybe you’re already doing that. Sometimes with high interval intensity training, there is some strength training in there, but if you’re not,

 

that might be an area that you could do a little additional work in. And the other thing I would say is that last slide we did in the presentation about the six out of 10 with Dr. Gretchen Howley, that might be a really good place to come back to and say, okay, am I doing all of these things? And is there a way that I can incorporate a few more of these into my practice? But I would say way to go, you’re actually doing a great job.

 

Lindsay, you want to do number two?

 

Yeah, thanks. So second question is, what are the most important exercises for somebody living with primary progressive MS? Or is it specific to each person? Oftentimes, it will be specific to each person because of the many different differences that we all experience and will be dealing with. I think it can help to have a specific personal trainer, of course, especially if you’re new to exercise.

 

Lyndsey Housden (45:33.774)

Things like chair yoga, Tai Chi, chair yoga where you might, you you have the benefit of having the support of the chair if you’re building confidence. Things like swimming as well where you also have the buoyancy of the water and then the enjoyment of the water to support you in that. Heather, is there anything you want to add into that?

 

No, the only thing I would add, maybe just this idea of it really there is not necessarily any specific physical activity or exercise that’s different for primary progressive. You know, again, depending on your disability and what assistance you need, that’s really the shift there, but it’s not like there’s different exercises.

 

Yeah, one thing I did want to mention is Phil Starten, who’s another who’s one of the OMS facilitators and is leading on the mindfulness and stress reduction pillar of the program. You’ll see him probably on many OMS webinars and things. He he I was discussing this with him and he said he personally really likes the MS Gym, which is an online website you can visit. And again.

 

Missing Link and Dr Gretchen, she has some fantastic resources online and talks a lot about exercises for people who are in the progressive stage of MS.

 

The only other thing that I’d add in there around this question is that idea, is it specific to each person? In an ideal world, all of our exercise programs would be specific to us because what my body looks like and what weakness, where my weaknesses are, are different than yours and are different than Lindsay’s, et cetera, et cetera. So in an ideal world, we’d all be getting this personalized training program. And so I would say if you have access to that, if that’s something that’s

 

Heather O’Neil (47:28.642)

financially help, you know, affordable to you or something you can access, it is really helpful to have someone give you a personalized routine and kind of look at where maybe you specifics, whether you have primary progressive or any other kind of So I just throw that in there.

 

Heather O’Neil (47:49.238)

Okay, so next question, I guess I’m up. The question is, what are the benefits of chair yoga? So the benefits of chair yoga are really very similar, the same as the benefits of yoga, right? You one of the things we talked about in the slides was that idea of, you know, stretching actually helps with inflammation in the body and stretching anywhere. So if you’re doing chair yoga,

 

You might be just stretching kind of the upper body or stretching, maybe you’re not stretching the whole body like you would in a regular yoga class, but you are still getting the anti-inflammatory impact in the entire body. And so the other benefit of chair yoga is if you have any balance issues, then it’s really much safer, right? You don’t have to worry about balance. You’ve got some safety there. It also might be helpful.

 

helpful, yeah, for any kind of assistance that you need, right? But the benefits are really the same as stretching and yoga, right? It’s gonna help with mood, because it’s gonna add serotonin and dopamine, and it’s gonna help with inflammation in the body.

 

Yeah, so the next question I have is what aids do you recommend for balance training? They give some examples like standing cushions, wobble boards, anything else. Well, the first aid I would suggest is a wall. If you are able to stand and you are, you know, you’re practicing just simply lifting up off the heels and back down again, perhaps training your ankles, strengthening your feet, any work like that. Just having the wall nearby is a free

 

and very accessible tool, well, part of the architecture. The second thing, something I like to use is this kind of wobble cushion. And this is something that I have by my desk and I can just stand up. I’ve got a higher desk here, which I can use for just checking my balance if I need to. And you can just practice standing on one foot, checking your balance. And the great thing with this one is that it’s got this lovely

 

Lyndsey Housden (49:55.449)

slightly painful side, which also helps to stimulate the soles of the feet and wake up the nerves on your feet. So that I found quite helpful. In many gyms you also have, Heather, what are they called? Those half balls that are sort of in… A lot of gyms have things like that as well. And many personal trainers will be able to give you, or you can also look online, some guidance on how to use that. Yeah.

 

We call it a BOSU ball.

 

Lyndsey Housden (50:24.662)

Over to you, I think.

 

Yeah, yeah. And please feel free if you have questions that are coming up or if you have questions on the previous slides that we talked about or even some of the guidelines. We’d love to hear them as well. Again, this is this interactive piece. So the next question that I have down there is, mentally can’t sit still. I live with primary progressive MS. I try to push myself every single day. And I feel like I rest enough. How much is too much? So I.

 

One of the things I would say I love, you know, hearing that you feel like you rest enough. means that you’re tuning into your body. Cause that’s probably the first in like how, how much is too much. One of the ways you might know that is if you’re not resting, right. if you’re doing kind of seven days a week and you’re not resting. So you really need to tune in to, what works for you. and good for you for pushing and doing things. This idea of I can’t sit still, right? This might be where that.

 

mindfulness and meditation comes in of like pulling some of that into some of the work that you’re doing with physical activity that might mean like bringing some yoga in. So you’re maybe helping your mind to kind of slow down a little bit that parasympathetic nervous system fill in, but how much is too much? You know, I think it’s really individual. I would say, you if you feel like you do a workout and then maybe for the next two days, you’re really wiped and you can’t.

 

actually do much, then it might be like, okay, wait a minute. Again, it comes back to can I do something consistently over time? If I’m doing something too hard and I’m not able to kind of function for two days or I’m having a lot of physical symptoms show up, that might be your body’s way of saying it’s too much. I think this is a hard one always because when you do physical activity and exercise, especially if you’re new to this, there’s gonna be some soreness.

 

Heather O’Neil (52:24.898)

there is going to be, your body is going to feel that. So I think it’s not realistic to say you’re not gonna feel any of that. You actually should feel some of that. That’s how you’re gonna know that your body is getting stronger, but you need to kind of be in that sweet spot of like, is it too much or is it not enough? And that’s tuning into the body a little bit, but good job for pushing yourself and also tuning in to know that you’re also resting. So I love that.

 

Just about the mindfulness and to bring our wonderful Phil back in again. He’s got some quite a few recorded meditation sessions from 10 minutes to 20 minutes to 30 minutes. I think they’re available. There’s certainly a few things available on the OMS website and the Livewell Hub. So if you’re curious and you want to step into it, but maybe not sign up for an eight week course, then yeah, there’s plenty of resources there.

 

Lots of overlaps between the physical health and the mindfulness are part of the, yeah.

 

Yeah, especially when you come to that idea, am I doing not enough or too much? It’s like really learning to tune into your body is really helpful. So I’ve got this next question. I want to get my teenage girls interested in something fun so I can work out, but also share the experience with them. Something like Zumba, any advice how I can convince them? So my daughters are now young adults, but I too have two teenage, have had two teenage girls in my house.

 

So I would say a couple of things to this. One is just, I love that you wanna get them involved and that share something with them. And I think starting there, right? Maybe just saying to them, hey, like, you know, I’m really trying to get more physical activity, exercise into my life. And I would really, you know, love to share this experience with you. So letting them know kind of, you know, why. The other thing that I often think about with teenagers and when I do some of my work,

 

Heather O’Neil (54:20.638)

as a clinical social worker is this illusion of choice, I call it. So it’s this idea where you might say, like, I really want to do more physical activity, and I’m really excited to share that experience with you. Would you guys want to do a Zumba class or walking or a yoga class with me? So it’s this idea that they have choice, but you really choose one. So it’s this gentle parent manipulation.

 

in a loving way, right? I think the other thing I would say to this is like this idea of just doing something for yourself as well. If they are really like, you know, depending on the relationship you have, it’s not, hopefully they’ll be like, yes, we’d love to do this with you, mom. But you know, that’s not always the relationship. Sometimes it’s a little bit more fiery. And so they might be not interested. And I would say just do it and kind of, you know, know that they also will see you doing this and see you taking care of yourself. And that’s a huge benefit in this relationship piece with teenagers.

 

Yeah, great. So the next question, are there any specific exercises to help manage fatigue and spasticity? This is something I can definitely connect with in terms of the symptoms. you know, the thing with fatigue is, again, it’s recognizing, do I actually need to rest? And do I need to rest guilt free?

 

That’s something that Dr. Gretchen also says, it’s important to recognise in that moment what is it that you need. At the same time, much of the research shows that as you’re consistent and you start to build up an exercise programme, that will give you energy, that will help you to develop stamina, to increase your energy.

 

It’s always tricky that that kind of moment of actually do I need to rest? Last night for example I really could have just slept but I did go to yoga it was a 45 minute class really lovely teacher and I came back sort of rested in a way that I could sleep you know so also in terms of for spasticity sometimes stretching is difficult and it might be that you want to find a foam roller you know something to help

 

Lyndsey Housden (56:37.656)

kind of massage and stimulate the muscles in different ways. So yeah, there’s not specific exercises that we can say right now because it’s cause it’s always different depending on what’s causing it. But I think movement in general is going to again, know, and stretching especially is going to release those anti-inflammatory molecules is going to building up stamina and being consistent will certainly help to increase your, your energy levels in general. And then recognizing when perhaps you just need to take a rest.

 

Heather, is there anything to add into that? It’s such a common question and I, yeah, difficult one.

 

Yeah, it’s good. This next question on there is, what assistive devices can support me when I try to exercise? So some of the simple ones that don’t cost any money, chairs, walls, Thera-bands can be helpful. Those are those like stretchy, you can put them on a doorknob and you can use those.

 

hand cycle, right? Hand cycle uses arms. It’s like a three wheel bike and allows you to kind of safely buckle in and use your hands to pedal and steer. Are there other things, that you have?

 

I mean, not assistive devices as such, just I mean, swimming pools can also be great because you have the whole support of the body and it might be that you want to, you know, have somebody there to assist you or to help you get in and out of the pool. And also, you know, sometimes you have these resistive even just many swimming pools have foam supports there to help keep you afloat or to use as resistance support. So, yeah.

 

Heather O’Neil (58:27.106)

Yeah, perfect.

 

Lyndsey Housden (58:31.178)

it’s me again. Any free at home programs as I don’t have the resources or ability to go to the gym? Yeah, great question. The OMS website in the Living Well Hub or the Living Well Hub. Both of those have loads and loads of short videos, many of them from Veronique, who’s the expert advisor in health, physical exercise. So you can find tons of different examples on there. There’s also the missing link.

 

classes with Dr Gretchen and Patricia Hawley also on on our OMS website. Yeah, so you can set, I would certainly start with that because there’s so many different MS specific exercise courses. You might find one that you really like and that’s just the one that you go back to. You know, there there is a lot to choose from. So yeah, just picking one or two and trying those for a few weeks and see how you get on.

 

Yeah, the MS Gym, I think you mentioned earlier, Lindsay, that’s also another one. One of the things in the United States is Yoga with Adrienne, which is a free online yoga. She doesn’t necessarily do adaptive yoga, but you can adapt it and she does a great job and again, those are very accessible.

 

Yeah, Heather, over to you.

 

Yes, over to me. So the next question on there is, what should I look out for when choosing a physical therapist? Do they need to work specifically with people living with MS, or will any be okay? How I would answer this one is, if you have access to a physical therapist that specializes in MS, I would absolutely try to do that.

 

Heather O’Neil (01:00:17.39)

And for good reason, right? People that kind of know how the disease shows up and kind of know the specifics to the body. So absolutely yes. But for some of us, that’s not an option, right? We might live in an area where that’s not available to us. We might not have access to somebody who has specialized training in MS. So physically, if that’s true, going to a physical therapist that doesn’t have that is also okay. I would talk with them, right?

 

connect with them just like any other provider, right? The relationship you have with a person is significant. you know, and most physical therapists, have a really good, you know, sense of the body. So they’re gonna be able to work with you if you say, okay, this is what I’m dealing with. I’m dealing with spasticity. But again, if you have access to somebody that specializes with MS, I would absolutely try to get someone who specializes.

 

And I have this next question as well. So this next question that was sent in was, I read that exercise promotes neuroplasticity in MS. Is that true? Yes, yes, and yes. Hopefully you guys can go back to that idea of how physical activity and exercise impacts the brain. Because yes, we are creating new neural pathways. We are creating neuroplasticity. Absolutely.

 

Yeah, just do also mention that if you want to keep learning more about neuroplasticity, there’s a really great webinar with Dr. Gretchen on the OMS website. So, yeah, you can dig back into that. And another thing that she says in relation to when you’re beginning out with with exercises, she says it’s so important that you’re basing your success not on the amount of movement that you’re making, but the amount of effort that you put in. And I think

 

I have to remind myself that as well when I’m feeling a bit disappointed or I’m not able to do what I used to do, it’s sort of like, yeah, I made the effort and that’s actually, you know, that’s the point of keeping that consistency and reminding yourself. Yeah.

 

Heather O’Neil (01:02:21.442)

Nice. All right. Yeah, we’re moving on to some live questions. So that first question is what is HIT in detail? and Lindsay and you and I can kind of piggyback this. So HIT stands for High Intensity Interval Training. And it’s really where you get your heart rate up to a pretty high level for a short period of time. And then you bring it down and get it back up again and you bring it down. Oftentimes.

 

Questions I think?

 

Heather O’Neil (01:02:50.99)

It can be, it’s usually done in kind of a class format where you might be, and sometimes there’s weights involved with that and sometimes there’s not. Sometimes it’s just aerobic fitness, but it really is targeting aerobic fitness, right? It’s trying to get your aerobic fitness up, which we talked about is an area that all of us with living with MS, you know, need to be focusing on, right? We need to be doing more kind of

 

aerobic exercise. So this is one way. Another thing for people with MS is it can be helpful because you have the high intensity, then it, you know, so if you have issues with heat, sometimes this is an exercise that could be helpful because you, you know, get your heart rate up, but then you bring it down, get it up and bring it down. So there’s a little bit of back and forth. I don’t know if you have anything to add to that Lindsay.

 

That sounds great. The next question is Pilates specific. So what about Pilates body resistance versus weights and bands? I think the question is, is one better than the other? I wouldn’t. Is that? Yeah. I mean, depends. It depends what you’ve got access to. And it depends. You know, yeah, I would say, I suppose if you’ve got the resistance

 

Are we talking about the bands or just also the machines? I wouldn’t say there’s too much difference because they’re dealing with resistance training in both cases and it depends what you have access to. Heather, do you have any extra thoughts on that?

 

Yeah, I mean, so some of this, right, comes back to what do you have access to, right? So if you have access to going into a flat A studio and working with the machines, great. If you have access to things, you know, in the house and that it works for you, great. But if you don’t have access to anything, doing body resistance is also great, right? This idea of just, want to be doing more physical activity and whatever capacity. So I always think, you know, let’s not shut things down because we don’t have the equipment.

 

Heather O’Neil (01:05:01.528)

Let’s try to figure out a way to move our bodies even if we don’t have access to that. So that’s probably how I would answer that.

 

Mm.

 

Okay, next question on there. Is it true that we should avoid exercise with high impact, such as jumping and running? So I have not heard this. I mean, so one of the things that I do is I actually am a runner. That is the exercise that I like to do. I don’t think there’s any necessarily exercise specific that we need to avoid with

 

and that’s, it’s just, it’s depending on you. If your body, if running and jumping does not work for your body, then let’s figure out how high impact, exercise does not work for your body or does not work for, sometimes right. There’s heat tolerance. That could be a barrier. So that might be a place where, but I don’t think it’s necessarily specific to MS. I don’t think it’s like, wow, we can’t, you know, you shouldn’t do high impact. I think that really is.

 

unique to you as an individual. If high impact doesn’t work for you, figuring out what does work again, you know, I think I mentioned in the slides before, doing exercise that you enjoy is kind of critical. We want this to be kind of a lifestyle change, not something you do and stop doing. So if high impact is not working for whatever, for your body, or because you just hate it, then finding a different way to do, I don’t know, Lindsay, would you add something to that?

 

Lyndsey Housden (01:06:35.566)

I totally agree and in terms of running if there’s something that you’re starting to do and you’re yeah whenever I try to go for a run I quite often end up going for a walk and then running a bit but there’s this great app called Couch to 5k probably a lot of you’ve heard of it and it’s just you know you’ve got someone in your ear who’s sort of your coach and then is kind of talking you through the program and it’s a nice way to kind of build up your stamina with that yeah that you don’t feel exhausted after kind of overdoing it.

 

So, please can you give some ideas to increase heart rate for someone who has very limited mobility? Yeah, so the great thing about cardio is that you can get great cardio workout. I’m not sure where your limited mobility is if it’s in your lower or upper body part or a mixture of both, but certainly again, Dr. Gretchen was talking about, no, actually Jody, Jody, we’ll come back to that reference later, but it’s also on the OMS website. It’s a physiotherapist who specializes in MS, Jody Barber.

 

she was explaining that she works with a patient who has very limited mobility, has mobility in one of their arms. And they’re able to get a decent workout, raise the heart rate by just working with one arm. it’s really, how can you find ways of increasing the heart rate? And you can do that really well with the upper body. Yeah, similarly with one or both legs.

 

So I would say in your case, if possible, finding a physiotherapist, I’m not sure if you’re based in the UK, but I would imagine you can get access to a physiotherapist. At least in North Somerset, I would be able to do that. Yeah, so yes, there’s absolutely ways you can do that. And great question. Thanks for bringing that up.

 

Yeah, I think that question comes up a lot and that is actually one of the places I would encourage people if you have a lot of mobility issues seeing a physical therapist to help you like, okay, what can I do? Because it would really give you some ideas about what your body can and can’t do, which we won’t be able to answer on a kind of collective webinar. yeah. Okay, next question.

 

Lyndsey Housden (01:08:48.462)

Yeah.

 

What do you do to assist with mental health when exercising and recognizing that you are no longer capable of what you once considered normal movement? Yeah, this is a good one. So my background, I’m a therapist, that’s what I do in my work. And so I often work with people on this idea of what’s the new normal. And there is a grief and loss process to it, right? There’s the sense of like,

 

I need to grieve maybe what I once was able to do and I have to step into like what I can do now. And so what we do know actually about exercise is exercise and physical activity really, really help with mental health. So I think in general, as you’re doing more physical activity, you’re going to, we’re gonna have less depression, there’s gonna be less anxiety. But there is this new normal that you deal with with a progressive disease, right? Of what I can do now.

 

and what’s my new normal. And so sometimes, if you’re having, if that’s a part of the struggle that’s really challenging for you, I would encourage you to maybe seek out some counseling, to talk about, to be able to grieve this old thing that I can no longer do and accept kind of who I am now and what I can do. Because that’s the other part of this is not, coming back to that neuroplasticity can happen.

 

at whatever disability level you are. So remembering that piece, right? Not just shutting it down like, I can’t do that anymore, so I shouldn’t do anything. Lindsay, I don’t know if you have anything to add to that.

 

Lyndsey Housden (01:10:21.004)

Yeah, only the I mean on the local so I’m part of the Bristol group and it can yeah, this is a topic that comes around a lot in the chat that we have. So I’d really recommend if you’re able to connect with the LiveWell Hub, look for your local group, see if you’ve got you know the community there, they’re going through it, they’re experiencing similar things and that might be another area that you can.

 

can find support. Yeah. The next question, can you recommend any exercises for back stiffness? Of course, it’s always hard to, if we say many times, it’s hard to recommend specific ones without really seeing. So it depends if it’s something where you have a sort of, you know, very much a pain or if it’s a general stiffness and general stiffness. think actually Heather, what you were doing with the cow and cat, you know, that’s something that you can do just sitting down. So simply flexing the back.

 

forward and backwards, starting off really slowly, trying to connect your breath with it, noticing the expansion of the rib cage, et cetera, because that’s also working towards the lungs will be also moving towards your spine as well. Even things like if you have the option, if you have a spongy yoga mat, right? So you can go onto the yoga mat and just rocking side to side ways to kind of self massage.

 

So any kind of low intensity mobility and some massage there that gets the vertebra moving and as regularly as possible. you know, sitting down a lot of course can just increase stiffness. So just getting up and trying to walk regularly, preferably outside where possible, walk or get some ability to be moving outside. Yeah.

 

Heather, anything you want to, I mean, I would say generally if you have really, you know, chronic back pain, then again, it’s about sort of seeking a specialist and someone to help with you. you know, generally speaking with stiffness, it’s about getting those joints moving.

 

Lyndsey Housden (01:12:29.78)

up and just, you know, take maybe rubbing some magnesium oil onto that gets getting so if you’ve got someone to do that for you is even better. But yeah, that’s another story. Heather, over to you.

 

Okay, can exercise aggravate night spasms, for example, when preparing to go to sleep? So this is a good question. know, exercise can aggravate some things at night, I think in general. for, mean, every, for me, for instance, I really work out in the morning. I don’t work out as, you know, close to sleep because that is not helpful for me to actually get good sleep.

 

So, you know, this is where you have to kind of figure out where do you have, where does exercise and physical activity fit into your life based on your body? So if you were finding that when you do exercise at night, it increases night spasms, then I would definitely try to shift that around and do it at a different time of day. And again, I call it a curiosity experiment, right? You’re being curious with your own body. Does that help? Does that make things better? What does that look like?

 

Lindsay, do you anything to add to that?

 

No, that’s yeah, I think some of the advice around exercise is to bring it if possible earlier on in the day just to try to create more of a restful experience and environment in the evening so you can help to sleep. But yeah. Yeah.

 

Heather O’Neil (01:13:58.414)

Okay, this last question.

 

I’m an analogue girl so you can answer that.

 

I’m not an expert, let’s, okay, does a normal smart exercise watch work the same for people with MS or is there any alternative option that would be better for us? I don’t know of an alternative option that would be better for us. I just use a normal, I just use a normal smartwatch, but if anybody out there in the community today hearing that, if there’s something that you know of, maybe put it in the chat so that, yeah, I’m trying to look and see if there’s any.

 

Moving with Emily. Okay, so we’ve got some things happening in the chat, but yeah, I just have a regular old smartwatch and nothing specific. So we’ve gotten through all of the questions today and there some really good questions. I want to do a little exercise.

 

I’m sorry, I really want to just interrupt you one second. Is that okay? I just did. Right. Just to say there were some community sessions suggestions in the chat. Somebody suggested moving with Emily is free. I don’t know what moving with Emily is, but I think Google will tell you what that is. Neuro Sask is in Canada, offers free chair exercises every Tuesday. Somebody recommended CBT and…

 

Lyndsey Housden (01:15:22.222)

Act therapy for support with accepting the condition. Yeah, act therapy is great actually. I haven’t tried CBT, but yeah, thank you. Heather, over to you. Just wanted to add that.

 

So we’re getting ready, we’ve just finished up all the Q &As, great job. I wanna just do a simple exercise before Lindsay and I close this out for today. And I want you to, if you have a piece of paper handy, just having it in a pencil or a pen, I want you to take a moment to just reflect on all of the information that we’ve talked about, whether you’ve heard something in the Q &A section or you’ve heard something in the slides.

 

But I want you to think about one small thing you can commit to going into this next week that you heard today around physical activity and exercise, something that you want set an intention for yourself. I want to, maybe it’s, I want to work out two, I want to do two exercise sessions next week, or I want to do, I want to add stretching into my routine next week, whatever that is. And just take a minute to think about what that might be for you.

 

And then when you’re ready, I’m going to have you write it down on a piece of paper.

 

Heather O’Neil (01:16:43.724)

And then the last thing, you have it written down on a piece of paper. The last thing I want to ask you guys to do is after this webinar gets done sometime today, I want you to share that out loud with someone. Maybe it’s a family member, maybe it’s a friend, coworker, child, somebody, because we know, you know, the research really shows that if we, you know, set an intention and we write it down and we say it out loud to someone, we’re more likely to follow through with it.

 

So kind of taking this today and I’m gonna let Lindsay kind of share some future things going on and then we’ll kind of wrap things up for today.

 

Yeah. So, yeah, let me.

 

Heather O’Neil (01:17:48.866)

Lindsay, you’re on mute.

 

Heather O’Neil (01:17:56.374)

Lindsay, you’re muted.

 

I’m not okay. I’m training you how to do that. Okay so upcoming events I’ll just catch to get to the point. We have an amazing event coming up on the 15th of November which is going to be a Live Well, a Living Well live event in

 

which will be a chance for you to ask all your questions about MS and healthy lifestyle choices where I can fill the 90 minutes now. So if you’ve, you can find all the information on live. The tickets have just gone live and there are quite a few, but limited early bird tickets. So feel free to check out now that event.

 

If you’re curious to, if you have any questions, there is also a webinar that Jake put out yesterday, which answered lots of questions. And one of the great things that they’re doing, which I think is fantastic, is that they’re making some personal assistance available for people who would be coming by themselves, but would need somebody to assist them during the event. So do check out that program.

 

Upcoming Monday the 12th, we have the much spoken about today, Dr Gretchen Hawley or Dr Gretchen from the Missing Link. She’s going to be doing a physical exercise class on the 12th of May. And if you’re really up for a challenge in exactly one month from today in Wales.

 

Lyndsey Housden (01:19:41.004)

You can join the fundraising challenge, which is a snow down, sunrise event on the 7th of June in Wales. So if you want to join that fundraising event at the last minute and you happen to be nearby, you can go and find that information on the website. Other useful resources, are you might find interesting. We talked today about Jodie Barber, who is an NHS physiotherapist and she’s been working for 30 years supporting people with chronic conditions.

 

She’s worked a lot with people with MS and she has, it was just actually about a month ago that she did a webinar and that is now available on the OMS resources. you can, and Jake will be sending a bunch of links also on Monday. So you can check out all of these there. So yeah, enjoy the Livewell Hub. Sign up, find your local community and.

 

Heather, over to you for the last words.

 

All right. We just have a big thank you to Lindsay for joining me today. We hope you enjoyed it. And just as a reminder, you’re going to receive access to the recording via Zoom next week. Thanks to Jake, who’s been behind the scenes in the background, kind of supporting the questions. We’ll be back with another webinar on the 9th of July, this time focusing on the overcoming NS diet with program facilitators Karen Lee and Ingrid Adelsberger.

 

And registration for this webinar will be open soon. So don’t forget to follow the Overcoming MS on our social media platform and check back in the website. And finally, just as a reminder, you’re gonna get a short pop-up survey after this webinar and let us know your feedback as it helps to shape future events and webinars going forward. So thanks, it was great to see everyone.

 

Lyndsey Housden (01:21:35.192)

Bye. Thanks. Bye. See you at LiveWell Live. It’s also hybrid, by the way.