I recently watched two presentations hosted by the MS Society of Canada that discussed some fascinating research into the recovery from MS symptoms.
The Exercise Question
My hobbies mostly involve physical activity and since diagnosis, with breaks for Lemtrada treatment, I continue martial arts and running. In those distant pre-COVID-19 days, I also was a regular at my gym and would go hillwalking. Apart from the treatment interruptions, I still exercise as much as I did before MS.
But should I?
I have asked myself this many times. Is it wise to continue hard training? Thus far, I’ve not experienced any negative effects. On the contrary, getting back to rigorous exercise feels good and I’ve been going on the assumption that this means I can carry on. Then an interesting tweet came across my Twitter timeline
“Does exercise promote repair of myelin?”
This would be the topic of presentations at MS Connect, an annual series of conferences hosted by the MS Society of Canada. These allow people affected by multiple sclerosis across Canada to hear about the most recent updates in MS research. The pandemic resulted in this year’s conference being online, making it easy for someone in Scotland to join in.
The session was hosted by Dr Wee Yong from the University of Calgary and Dr Michelle Ploughman from Memorial University of Newfoundland. Dr Young’s topic was “exercise is good for brain health and repair of brain lesions” whilst Dr Young discussed promoting “neuroplasticity and restoration of function in multiple sclerosis”.
You can watch the presentations below.
Can Exercise Promote Remyelination?
I found both presentations fascinating. Dr Yong first spoke about how Disease Modifying Therapies, such as Lemtrada, prevent immune attack. However, they do not directly promote remyelination. The question is can lifestyle or exercise promote this?
Initial studies and some animal testing would seem to say yes. The next goal would be to establish medical treatment that would promote remyelination. Encouragingly there is a lot of research in this area. I was training several times a week before the onset of symptoms so seemingly that alone is not enough to maintain myelin. Dr Yong then introduced the term “medXercise” for the combination of exercise and treatment that would work together to restore brain function.
How much physical activity is required? The general recommendation for adults is 150 minutes per week and the guidance for MSers was the same, to maintain wellbeing. More research will establish how much would promote remyelination.
Dr Ploughman then spoke of “promoting neuroplasticity”. Initially this was based on research into the rehabilitation of stroke payments.
Physical activity is encouraged to prevent decline, but could it also promote recovery? In a study, MSers are shown to have a very low level of fitness. Pre-MS, my fitness level was high, and I wonder if that has helped me recover? If my hobbies were less active, would the MS symptoms be a lot worse? Conversely did my mental health suffer because at first, I couldn’t do the things I enjoy. Swings and roundabouts really and I try not to torture myself thinking about it. At least not anymore.
This lower level of fitness is “related to the inhibition of brain circuits in MS”. Again, the question is how much activity does this require? Dr Ploughman suggests three to five times per week, of at least 30 minutes each time, at a level of intensity greater than 60% of your maximum. A minimum of eight weeks of such a program is required.
However, as lot of MSers suffer fatigue whilst others find that increases in body temperature can exacerbate symptoms. Research is being done on how to alleviate these and is there still an effect from the training.
Reasons to be Optimistic
So, two interesting presentations, which give me an added incentive to continue training as much as possible. I appreciate that I am fortunate in that my MS symptoms are relatively mild. There’s a tingly left leg and back but I am still mobile. I don’t have fatigue and the increased temperature during exercise doesn’t appear to cause any issues.
The recent clinical trials for remyelination treatments, coupled with exercise promoting as a natural regeneration are hugely encouraging. We could be looking at definite medXercise program soon which would be a game changer for so many MSers. It’s a validation for me to continue training as much as possible. It’s fun, I enjoy it. It is good for my general health and mental wellbeing. And now, it just might help me recover from MS symptoms. What’s not to like?
Thanks to the MS Society of Canada, Dr Yong and Dr Ploughman for these fascinating presentations. I’ll look forward to more MS Connect sessions in the future.