This past week I found out that the son of someone dear to me was diagnosed with Multiple Sclerosis (MS). After the initial shock and sadness passed, my immediate response was, “He should take Pilates!” I’ve had the opportunity to do Pilates-based Physical Therapy with a number of people with neurological conditions, MS being one of them. Upon doing a bit of background research, I felt both excited and validated to find a number of articles supporting Pilates as having significant benefits for people with MS. MS is a bit enigmatic to both the common population and doctors alike. We don’t know what causes it, what makes the disease progress or how to cure it. However, what we are starting to discover is how to manage the disease and improve quality of life for those that have it.
Let’s start off with the WHAT. MS is a degenerative neurological disease which affects the myelin sheath of the central nervous system. When this protective covering begins to deteriorate, the messages getting sent from the brain to the rest of the body are slowed down or altered. While variable from person to person, some of the most common symptoms of MS include numbness, weakness, problems with vision, fatigue, heat intolerance, altered cognition, pain and depression. In general, the disease onset happens between ages 20-50 and is more common in women than in men (at least 2-3 more times according to the National MS Society).4
Historically, it was thought not to allow people with MS to participate in any type of exercise at all for fear of exacerbating symptoms. That mentality is slowly but surely starting to fade away as we gain more knowledge on not only the complexity of this diagnosis, but also how to treat (or train) the person with MS. Recent research supports the fact that physical activity in people with MS can actually reduce the inflammatory process thus prolonging the potential for a relapse.1 In this specific study, the intervention performed was 12 weeks of Pilates combined with aerobic exercise and researchers found that people with MS were better able to manage their fatigue post intervention.
So WHY Pilates? It’s low-impact, it addresses strength and balance deficits in a safe environment, it challenges the mind, it improves body awareness thus decreasing any significant/rapid increases in body temperature, and most importantly, it makes you feel good! A 2015 study showed that implementing a Pilates program 2x/week for 8 weeks demonstrated significant improvements in balance, fatigue management, cognition and quality of life in people with MS.3 Similarly, Kalron et. al., found that both Pilates and Physical Therapy enhanced performance in people with MS as both groups demonstrated significant improvements in walking speed after intervention.2
So for those of us that are Physical Therapists or Pilates instructors, HOW do we implement all this knowledge into practice? There are some precautions to take into account when working with people with MS.
What to watch for:
- Extreme temperature changes (make sure studio is air conditioned)
- Not adapting the “No pain, No gain” mentality
- Allow for person to take rest breaks as needed
- Guard closely with balance activities
It is still very possible to give someone with MS a challenging and rewarding session while staying within these guidelines. Respect the disease but have fun with creating a program for your clients!
The message is clear: Having a degenerative neurological condition does not have to imprison you in your own body! If you or someone you know has MS and is interested in taking Pilates, make sure to see a medical doctor or physical therapist first to receive clearance for participating. For more information on Multiple Sclerosis, a good resource is The National MS Society website (www.nationalmssociety.org )
-Kelsey Garcia DPT, PMA-CPT
- Alvarenga-filho H, Sacramento PM, Ferreira TB, et al. Combined exercise training reduces fatigue and modulates the cytokine profile of T-cells from multiple sclerosis patients in response to neuromediators. J Neuroimmunol. 2016;293:91-9.
- Kalron A, Rosenblum U, Frid L, Achiron A. Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: A randomized controlled trial. Clin Rehabil. 2016;
- Küçük F, Kara B, Poyraz EÇ, İdiman E. Improvements in cognition, quality of life, and physical performance with clinical Pilates in multiple sclerosis: a randomized controlled trial. J Phys Ther Sci. 2016;28(3):761-8.
- National MS Society http://www.nationalmssociety.org/