Enabling Fitness Environments and Empowering People with Multiple Sclerosis to Increase Exercise and Improve Health

Article Review: A Qualitative Analysis of a Progressive Resistance Exercise Programme for People with Multiple Sclerosis

Secondary conditions can take the form of physical, environmental, and social consequences that impact the health of people with disabilities. In the journal Disability and Rehabilitation, Dodd, Taylor, Denisenko, & Prasad (September 2006; 28(18): 1127-1134) explored perceptions of a progressive resistance exercise program for adults with multiple sclerosis. Barriers and facilitators to exercise can become important determinants of long-term adherence to fitness and health promotion programs, which can help to mitigate or prevent secondary conditions such as fatigue, pain, and muscular weakness.

The study reported interview results with seven women and two men with multiple sclerosis ages 27-61 years (average age 45.6 years) who participated in a twice weekly 10-week progressive resistance strengthening program. Participants were asked to report positive and negative outcomes from the program in addition to the types of factors that motivated them.

Social Support

Among the social benefits reported were: a) increased companionships and friendships with other exercisers in the group; b) appreciation of encouragement from other participants; and c) feeling comfortable in an exercise environment that included others with a similar disability.

Negative Outcomes

Several participants reported musculoskeletal pain and muscle soreness primarily during the program onset. Other negative outcomes included fatigue precipitated by the exercise, although an overall decrease in fatigue was reported as a major benefit by several participants. Other program-specific comments included lack of exercise variation and lack of adequate warm-up prior to beginning the exercise program.

Program Participation

Among the most encouraging findings from this study were reports that improvements in muscular strength resulted in carryover into daily functional activities such as safety during walking, the ability to open containers more easily, and improved performance when walking up stairs. Another key finding was the comfort many participants reported in becoming accustomed to an exercise environment, which the authors point out could add to an individual's ability to customize his/her own exercise program in a familiar environment.

Given the complexity of secondary condition prevention, health promotion programs that include customization and involve a myriad of facilitators such as social support from fellow exercisers and familiarization with fitness environments are vital to long-term sustainability. We can learn from the feedback provided within this study that social support from others who face similar barriers can increase motivation and participation within fitness environments and programming that might otherwise be difficult to initiate for people with disabilities. It also appears that, although exercise programs may initially cause pain and muscular soreness in some people with multiple sclerosis, these effects generally do not continue past an initial exercise phase. Regular exercise is a major contributor to cardiovascular health improvements, which, among these study participants, translated into improved daily functioning. Long-term effects of these improvements may include promotion and sustainability of independent living for people with disabilities. Therefore, for people with multiple sclerosis and other disabilities, regular exercise and enabling and empowering exercise environments may prevent or mitigate common physical secondary conditions (i.e., fatigue, muscular weakness) as well as alleviate environmental secondary conditions (i.e., customizing social support structures, accommodating fitness environments).

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This fact sheet was last updated on 02-19-2007.