I would suggest trying High Intensity Interval Training (HIIT) where you work really hard for shorter time (30, 60 or 90 seconds) and then rest for twice the time. Plus, making sure you stay cool (drinking cold water, wearing a cooling vest or scarf, exercising in a cool place..). People suffering from fatigue tend to better tolerate HIIT than other forms of exercise because of the pauses in between.
For a person who is very weak, I would suggest to focus on breathing exercises like 'Pursed lip breathing' and 'Belly breathing'. They will help to stretch and strengthen the respiratory muscles. Then, if/ when available, any movement will help too. It could be stretching, walking.
Many people have one side weaker than the other. It's normal. But if one side is much weaker the key is to focus on one-sided exercises and start with the weak side. If the exercises require weights, you should use the same weights for both sides and choose them based on the ability of the weakest side. Do the same number of repetitions on both sides.
Yoga has been found to have very positive physical effects on people with MS, improving their strength and stability whilst reducing pain and fatigue. It also has a positive mental impact by easing stress. Yoga is a very flexible form of exercise which can practiced by anyone with MS. Even if someone has low strength, balance or mobility, yoga routines can be adapted to suit their needs. Helpfully for people with MS, yoga can be done in sitting on the floor, in a wheelchair, standing or lying down.
The main styles of yoga are:
- Hatha - gentle and slow physical postures.
- Ashtanga - fast, demanding movements.
- Vinyasa - a less vigorous version of Ashtanga which incorporates music.
- Iyengar - uses props and long-hold postures to build strength.
- Restorative - users are held in a comfortable pose for 5-10 minutes using blankets and blocks.
- Yin - a longer form of restorative yoga.
- Chair - yoga practiced either by sitting on a chair or using a chair for balance.
- Adaptive - altering yoga poses so that they can be practiced by disabled people.
- Yoga therapy - using a mixture of poses, meditation and breathing to improve specific symptoms such as stress.
There is also bikram yoga, however this is not recommended for people with MS as it takes place in hot rooms and aims to make the user sweat. Heat can often make MS symptoms worse.
There are various types of yoga, and many different teachers, so finding the choice that is right for you is key. There may be specific classes for people with MS in your area, although you can also ask individual teachers at yoga studios if they run classes which would be suitable for you. You can also research registered yoga therapists on the International Association of Yoga Therapists’ website.
If you can, try to aim for 30 minutes of exercise five times per week.
IMPORTANT: Consult your doctor or a specialized fitness professional if you are new to exercise or have active symptoms such as:
- Difficulty with balance and coordination
- Heat intolerance
- Visual changes
Regular exercise has been shown to slow the progression of multiple sclerosis and make premature death three to five times less likely. Exercise also build strength and flexibility allowing you to maintain or even increase your mobility.
It also noticeably improves the quality of life for people with MS by reducing fatigue and depression, whilst helping cognitive functions like memory and concentration. It has been shown to increase muscle strength, walking speed, and improve bowel, bladder and sexual functions.
Aerobic exercise that lifts the heart rate and makes you sweat is ideal – walking briskly, jogging, swimming, rowing and aerobics are all good ideas. Having built up fitness, strength training is important for making sure that muscles remain strong. Yoga and pilates are also beneficial for increasing strength and flexibility.