| Cardiorespiratory/Aerobic Exercise For People With MS |
|
Cardiorespiratory exercise or aerobic exercise is designed to improve conditioning
of the cardiovascular and respiratory systems. The cardiovascular system includes
the heart and blood vessels. The respiratory system primarily includes the lungs.
These systems are trained through aerobic (with oxygen) exercise. Aerobic exercise
allows the heart to pump blood, carrying oxygen, to the working muscles.
The heart is a muscle and must be trained like any other muscle in the body.
A conditioned heart will enable one to work for longer periods of time before
fatigue, allow quicker recovery from exertion and decrease the risk of cardiovascular
disease. In addition, aerobic exercise can help with reduction in body fat, improve
blood lipid profiles (i.e., cholesterol, triglycerides, etc.), assist with stress
reduction and improve psychological and emotional well-being.
Any physical activity that includes continuous, rhythmic movements of large muscle
groups is considered aerobic exercise. Aerobic exercise includes, but is not
limited to, swimming, cycling, walking, jogging, dancing, rowing, pushing a
wheelchair and upper body ergometry. In order to gain the benefits of aerobic
exercise, it is important to participate in the activities on a regular basis.
Therefore, it is important to find an activity (or varied activities), which is enjoyable.
Once the type or mode of activity is determined, it is important to determine
the frequency, intensity and duration of the activity. If initiating an exercise
program, it would be beneficial to consult a physician, physical therapist or
exercise physiologist with experience in managing people with MS. A cardiovascular
fitness evaluation may be appropriate to rule out any cardiac problems.
In addition, this evaluation can provide additional information related to the
proper exercise intensity and duration.
Exercise intensity can be measured through different methods. Traditionally,
exercise intensity is measured by checking heart rate or pulse rate. Aerobic
exercise is then prescribed within a “target heart rate” zone. If the intensity
is too high, or outside the target zone, then the exercise becomes anaerobic
and the conditioning benefits are changed.
For people with MS, target heart rate zones may not be the most effective means
of monitoring exercise intensity. Many people with MS have problems with sensation
and may not be able to detect an accurate pulse rate. In addition, some people
with MS have altered cardiovascular responses to exercise. The mechanism of this
response is not clear but may be due to an abnormal response in the autonomic
nervous system (Pepin, et.al., 1996). Another study suggests that the abnormal
response is due to differences in a muscle metabolic response to exercise.
(Ng, et.al., 2000). Because of the difficulties with heart rate monitoring, a
rate of perceived exertion (RPE) scale is often recommended. The RPE scale is
a subjective rating based on a scale of 0-10 and is used to monitor effort and
fatigue with activity. After the appropriate RPE is determined (based on a
cardiovascular fitness evaluation), it will provide a consistent method of
monitoring exercise intensity while decreasing fatigue from “overdoing” it.
Exercise duration is also an important factor to consider when starting an exercise
program. As little as ten minutes of activity can provide cardiovascular benefits.
Progression of exercise duration should be done slowly to avoid the symptoms of
fatigue and overuse injury. Progressing exercise duration by 10% per week will
reduce the problems associated with overdoing it and will permit development of
a healthy habit.
Another aspect to consider when starting your exercise program is the frequency
of the program. The optimal frequency for aerobic conditioning is to start with
three times per week with progression to five days per week.
Some tips for success with your aerobic or cardiorespiratory program are:
- Avoid using absolute amounts of work (i.e., mileage, speed, distance)
to measure your exercise program because you will have good days and bad days.
It is better to use exercise duration (time) as your measure.
- You should feel as well or better two hours following your exercise
program as you did when you started. If you don’t, you probably did too much.
It is OK to back off.
- It is what you do every day that counts not what you do on one day.
Be consistent with your exercise program. If you miss a day it is OK, but don’t try
to do two days of exercise because you missed the previous day.
- Try not to miss more than two days in a row. There will be times you are not
able to participate in your exercise program, because of family commitments, meetings, etc.
Have a goal to schedule so you don’t miss more than two days in a row.
- If you are heat sensitive, plan your aerobic exercise in a cool environment or
consider cooling aids such as vests, cool towels.
- Drink plenty of water before, during and after your exercise session.
- If you are having trouble getting started, think about exercising as part of a group.
Studies have shown that adhering to an exercise program is increased when
participating as part of a group.
Aerobic exercise can and should be fun. Developing an exercise program with
the help of your healthcare professionals will allow you to have greater success
and enjoy the benefits associated with an exercise program.
|
| - reprinted with permision from- The Heuga Center. |
|
|
|
|
|
 |
Send This To A Friend |
|
|
