MULTIPLE SCLEROSIS, EXERCISE AND ELECTROSTIMULATION
Many have heard of multiple sclerosis (MS), but perhaps few know what this disease entails. It is a chronic disease of the Central Nervous System that can present in several types: remitting-recurrent, secondary progressive, primary progressive and relapsing progressive.
What happens in MS is that myelin disappears from some areas of the brain. Myelin is a substance that envelops the axons of some nerve cells and contributes to the speed of impulse transmission. Therefore, this function is deficient when MS occurs, since the demyelination of some areas causes “scars” that impede the ability to transmit the nerve impulse.
Approximately 47,000 people in Spain live with this disease, and its symptoms can be diverse: fatigue, visual disturbances, balance and coordination problems, spasticity, sensory disturbances, speech disorders, bladder and intestinal problems, sexuality problems and intimacy, cognitive and emotional disorders.
For decades, people with MS were advised not to engage in physical exercise, for fear of worsening the diagnosis and increasing fatigue and other symptoms. However, the latest research indicates that physical exercise should be included in the treatment of MS, since it is useful to manage symptoms, prevent complications and comorbidities, and even the possibility of having neuroprotective capacities is considered.
In fact, physical inactivity is likely to contribute to comorbidities such as obesity, metabolic syndrome, or osteoporosis. For example, obesity is a risk factor for the development of MS in adolescents. Or it is also indicated that people with MS who also have hypertension or diabetes have a worse prognosis.
Unfortunately, people with MS appear to be less physically active, as fatigue, deterioration, and lack of time are the main barriers to starting an exercise program.
Scientific evidence suggests that both aerobic and strength exercise can benefit people with MS. One of the protocols used by Dalgas et al. (2008) used an intervention of 2 weekly sessions, one for resistance strength and the other aerobic, lasting from 10 to 40 minutes, and with a heart rate intensity of 60-80%.
Interestingly, electrostimulation has also been used to improve some of the symptoms of MS. Here we bring you the latest evidence that shows its benefits.
Twenty people with MS and drooping or pendulous foot were selected, with a mean age of about 50 years. They were divided among those who walked more or less than 8 meters per second. All walked with or without electrostimulation for 5 minutes. Those who walked slower obtained significant improvements with electrostimulation. That is, the use of electrostimulation while walking appeared to be more effective than walking without it (Miller et al., 2015).
In another investigation, 153 people with MS with pendulous or drooping feet completed an intervention in which they electrostimulated the peroneal nerve. The intervention lasted 20 weeks. This caused the walking speed to increase significantly (Street, Taylor & Swain, 2015).
Another intervention concluded that electrostimulation as part of rehabilitation helps preserve or improve neurological function in patients with MS. This is because in the patients who included electrostimulation in their intervention, there was no progression of disability, which is quit
A study with a smaller sample (seven men and one woman) investigated changes in muscle oxygen consumption after four weeks of electrostimulation training in people with MS. Participants pedaled 30 minutes per session, 3 days a week. Electrodes were placed on the quadriceps, and the frequencies ranged from 2 to 7 Hz. Muscle oxygen consumption increased 47%. The improvement was good, so this type of training seems to be an alternative to improve muscle health in people with .
It is important to bear in mind that studies 1 to 3 on electrostimulation in people with MS refer to rehabilitation, so we must specify the following: physical therapy (or therapeutic exercise) can be defined as a structured set of exercises and strategies designed to overcome a specific deficit; while physical exercise, to which study 4 refers, is planned, structured and repetitive physical activity carried out over a prolonged period to maintain or improve physical fitness and functional capacity.
There is still much to know, but a priori it seems that electrostimulation could be another tool to use in training in people with MS. It would be interesting if they explored the effects of Active Integral EMS in people with multiple sclerosis, but until then we are left with the evidence that indicates, with caution, that electrostimulation itself may be an option.
Dalgas, Ingemann-Hansen and Stenager. Multiple sclerosis and physical exercise: recommendations for the application of resistance, endurance and combined training.
Giesser. Exercise in the management of persons with multiple sclerosis. Ther Adv Neurol Disord.
Hammond et al. Functional electrical stimulation as a component of activity-based restorative therapy may preserve function in persons with multiple sclerosis. J Spinal Cord Med.
Miller et al. The impact of walking speed on the effects of functional electrical stimulation for foot drop in people with multiple sclerosis. Disabil Rehabil Assist Technol.
Reynolds et al. Pilot study: evaluation of the effect of functional electrical stimulation cycling on muscle metabolism in nonambulatory people with multiple sclerosis. Arch Phys Med Rehabil.
Street, Taylor and Swain. Effectiveness of functional electrical stimulation on walking speed, functional walking category, and clinically meaningful changes for people with multiple sclerosis. Arch Phys Med Rehabil.