Exercise Is Medicine Multiple Sclerosis Case Study: Effect Of Strength Training On Multiple Sclerosis Fatigue

The National Multiple Sclerosis Society defines multiple sclerosis (MS) as a disease that damages the myelin sheath, disrupting signals to and from the brain. Some common yet unpredictable symptoms with MS include numbness, memory problems, pain, fatigue, blindness, and/or paralysis. “Alyssa,” a very active 43 yo female with relapsing-remitting multiple sclerosis (RRMS), volunteered to participate in an 8-week fitness program, Community Fitness Partners. Alyssa was given an exercise prescription based on the FITT principal recommendations for muscular strength, which was her chosen goal. PURPOSE: To determine the effectiveness of muscular strength training to decrease fatigue in RRMS individuals. Fatigue is one of the most common symptoms of MS and muscular strength training has been shown to improve symptoms and overall quality of life. Further improvements in muscular strength and exercise adherence were also desired. METHODS: An informed consent and a PARQ+ was obtained to determine readiness for physical activity. Goal setting and a health/fitness screening were completed. Her vitals were: body mass = 85.4 kg, height = 1.64 M, HRrest = 64 bpm, and BPrest = 134/80 mmHg. For the muscular strength assessment data, a handgrip dynamometer and an estimated 1-RM leg press protocol was utilized. Her 8-week program consisted of 2 d/wk strength training, one lower body focused day and one upper body focused day. She also attended a “boot camp” 3 d/wk that focused on a combination of HIIT style and strength training. Alyssa completed the Modified Fatigue Impact Scale (MFIS) to assess her fatigue levels post program. RESULTS: Alyssa’s best hand grip pre-training was 13.43 kg and post training was 14.92 kg, indicating an 11% increase. Her estimated 1-RM on the leg press was 90.72 kg pre-training and post-training it was 115.21 kg, indicating a 27% increase. Her total MFIS score was a 26 out of 84. She reported that before the 8-week program, she would have answered “often” for the majority of the questions, instead of “rarely”. CONCLUSION: An 8-week muscular strength training program was effective in decreasing fatigue symptoms and increasing muscular strength in a subject with RRMS. Muscular strength training allows individuals with MS to exercise without overheating, thus exasperating symptoms, as seen with aerobic training.