• A recent study found that a variety of physical activities, such as aerobic, strength, balance, and resistance exercises, may be best for fighting fatigue related to multiple sclerosis (MS).
• The study found that mind-body exercises such as yoga were especially effective for those with mild-severity MS, and resistance exercises yielded the best results for those with moderate MS.
• Regular exercise can provide more autonomy and a better quality of life to individuals with MS.

Fatigue is one of the most common and disabling symptoms for people living with multiple sclerosis. About 80 percent of individuals with MS say they’ve experienced a lack of physical or mental energy that interferes with their daily activities, according to the National Multiple Sclerosis Society.

To help improve function, movement, and muscle strength, a health care provider may recommend a regular exercise program to prevent deconditioning. Scientists from Spain recently took a closer look at how physical exercise may reduce MS fatigue, evaluating the effectiveness of different types of activity based on disease severity.

Based on patient-reported data from 58 randomized control trials representing 2,644 participants diagnosed with MS, the study found that combining different types of exercise is the most effective approach for improving both physical and total fatigue.

“In general, exercise should be considered an effective fatigue management strategy for people with MS,” said Dr. Ana Isabel Torres-Costoso, a professor of physiotherapy at University of Castilla-La Mancha in Toledo, Spain and the lead study author. “Also, our analyses show that the duration of exercise is directly related with the effect,” she told MyMSTeam.

The exercise interventions included from the 58 investigations were categorized as:

• Aerobic
• Resistance
• Aerobic with resistance
• Balance
• Combined exercise
• Body weight support
• Mind-body exercises (such as yoga or Pilates)
• Control

This meta-analysis detailed that aerobic exercise examined in this review included interventions aimed at increasing energy expenditure and heart rate for a sustained period, such as treadmill, cycling, or walking.

Another recent study found that aquatic exercise was especially effective in reducing fatigue for people with MS.

Mixing Exercise Types Proved To Be Beneficial

The study authors discovered that to improve the physical component of fatigue in people with mild MS, combined exercise that includes two or more physical activities during the same session (such as a mix of coordination, balance, and strength exercises) was most beneficial.

Combined exercise also improved overall fatigue for those with mild or moderate MS. Researchers pointed out that these physical activities could improve muscle strength and postural control, which in turn could lead to better cardiorespiratory capacity.

Dr. Torres-Costoso noted that for mild-severity MS, mind-body activities were particularly beneficial, such as balance-based exercises focusing on breathing and postural control (Pilates or yoga, for example).

Learn more about yoga and MS.

For those with moderate MS, Dr. Torres-Costoso highlighted resistance training, aimed at increasing muscular strength and power. This form of exercise provided the greatest positive effect for total fatigue, according to the study.

There were not enough studies to make any solid conclusions about which exercises are best for severe MS, Dr. Torres-Costoso said.

“Because fatigue is one of the most common and devastating MS symptoms, exercise should be considered as a pivotal therapeutic strategy in the management of MS because it improves the functional autonomy and quality of life,” the study authors wrote. “In summary, combined exercise appears to be the most effective type of exercise for both physical and total fatigue.”

The National Multiple Sclerosis Society provides several videos and suggestions regarding exercises for people with MS. Learn more about MS and exercise.