Physical activity lowers risk for disability worsening in multiple sclerosis

Key takeaways:

• A study examined the effects of exercise in 3,000 patients with MS for up to 15 years.
• More physical activity following diagnosis was associated with improved outcomes across four intensity levels.

WEST PALM BEACH, Fla. — For patients with MS, the risk for disability worsening was reduced with physical activity, highlighting the importance of recommending it in practice, researchers reported at ACTRIMS.

“It’s important to find out what the patient can do themselves with a goal to improve their prognosis,” Lars Alfredsson, PhD, senior professor at the Institute of Environmental Medicine at Karolinska Institute in Stockholm, told Healio. “Physical activity is one such thing.”

Alfredsson and colleagues evaluated the association between varying levels of physical activity and disability progression in MS, as measured by the Expanded Disability Status Scale (EDSS).

Their study culled data from the Epidemiologic Investigation of Multiple Sclerosis as well as the Swedish MS registry, yielding 3,284 patients whose disease progression was tracked for up to 15 years.

Physical activity was divided into low (fewer than 2 hours per week of ambulation); moderate (walking or cycling at least 2 hours per week); moderate-high (regular exercise that induces sweating at least 30 minutes one to two times per week); and high (exercise at least 30 minutes three times a week that induces sweating) levels at baseline. The primary outcome was time to confirmed disability worsening (CDW) as well as EDSS scores of 3 or 4, indicating a greater level of MS disability.

The researchers’ analysis models were adjusted for variables such as age at MS diagnosis, sex, baseline EDSS and type of disease-modifying therapy.

According to the results, the risk for CDW was reduced for moderate, moderate-high and high levels of exercise compared with low, with all types of physical activity decreasing the risk for an EDSS score of either 3 or 4. These findings were consistent, Alfredsson and colleagues noted, with respect to clinical and lifestyle variables.

Data additionally showed that an increase of physical activity level following diagnosis was associated with improved outcomes across all four exercise strata, suggesting that regular physical exertion is likely to produce neuroprotective effects and future clinical benefit.

“The patients can choose whether they want to increase their physical activity,” Alfredsson told Healio. “Even when having the disease for a while, if you increase your level of activity, it is better.”