Have you ever seen Legally Blonde or Cruel Intentions? If so, you are probably familiar with the actress Selma Blair. In October 2018, Selma took to Instagram to share that she was recently diagnosed with multiple sclerosis, or MS. As a famous actress, the appearances she has made to discuss her diagnosis have brought more attention to this chronic disease. I only knew a bit about MS before she discussed her diagnosis publicly, and after she started sharing more about how it affects her life, I decided I wanted to learn more.

Multiple sclerosis is a disease of the central nervous system, meaning it greatly affects the brain and spinal cord. Lesions can be seen in these areas on an MRI (with contrast) of a person with MS. The immune system attacks the myelin covering nerve fibers, creating issues with communication between the brain and the rest of the body and disrupting the flow of information. (5) Interestingly, the cause of MS is unknown, but environmental and genetic factors seem to contribute to the risk of developing MS. (5)

MS has multiple symptoms, which vary between people and depending on the course of the disease. Some are as follows: (5)

• Numbness / weakness in one or more limbs
• Electric-shock sensations with certain neck movements
• Tremor, lack of coordination
• Slurred speech
• Fatigue
• Dizziness
• Bladder / bowel problems

People are often diagnosed between the ages of 20 to 50, and two to three times more women are diagnosed than man. Although it is not exactly known why women are more at risk, the rising incidence may have some relation to body fat. Women carry more fat on their bodies than men, and belly fat is associated with increased inflammation. Another reason that may contribute to potential flare-ups is related to pregnancy. Some women with MS have a lessening of symptoms when pregnancy, but then have a flare-up after having the baby. There needs to be more research to determine why men are less diagnosed, but these two reasons give a potential reason women may have more flare-ups. (1)

Besides sex, there are also other risk factors for being diagnosed with MS. Some are as follows: (5)

• Age
• Sex
• Family history
• Certain viruses linked (Epstein-Barr)
• Smoking

Now, let’s talk about what a relapse is in multiple sclerosis. Essentially, this is when a person has a period where their symptoms are severe, and the deficits are persistent for at least 24 hours. Relapses often involve abnormalities in sensory, motor, cerebellar, or visual system abnormalities. Examples of issues a person may face in a flare involve blurry vision or numbness and tingling. (2)

There is not a cure for MS. Also, many treatments cause flare-ups and major relapses, which makes it so that many people cannot pursue some methods that are known to help others with MS. Some treatments are corticosteroids, which can help reduce nerve inflammation. Also, plasma exchange can be used. This is when plasma is removed from blood and separated from blood cells, which are mixed with a protein solution and put back into the body.

Although corticosteroids and plasma exchange can be used, an interesting newer tactic that helps some people with flare-ups (without potentially worsening them)… Surprise, it’s exercise!

This is a relatively new area of research within MS. One of these studies found that aerobic exercise can increase muscle strength, flexibility, balance, cognition fatigue, respiratory function, and overall quality of life in MS patients. This is exciting because all of these areas can be greatly affected in someone with MS. For example, the study showed that aerobic training at low to moderate intensity can reduce fatigue in MS patients who are mildly or moderately affected. Exercises to help with balance can help decrease fall rates. (3)

Another study was done with aquatic exercises and MS, where it also appeared that it may improve balance impairments. Findings showed that there were statistically significant improvements in static and dynamic balance in patients with MS. There were also improvements in gait ability. (4)

I find the idea that exercise can help alleviate symptoms of MS to be so fascinating. Although there is not a cure, this is a good way to help people keep their body as healthy as possible while making them also feel better.

References:

1. Calabresi, P. “Multiple Sclerosis: Why Are Women More at Risk?” Johns Hopkins Medicine Health Library. https://www.hopkinsmedicine.org/health/conditions-and-diseases/multiple-sclerosis-ms/multiple-sclerosis-why-are-women-more-at-risk.
2. “Clinical and Biological Features: Current Status and Strategies for the Future.” Multiple Sclerosis: Current Status and Strategies for the Future., U.S. National Library of Medicine, 2001. https://www.ncbi.nlm.nih.gov/books/NBK222386/.
3. Halabchi, F., Alizadeh, Z., Sahraian, M. & Abolhasani, M. (2017). “Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations.” BMC Neurology. 17(185). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602953/pdf/12883_2017_Article_960.pdf.
4. Methajarunon, P., Eitivipart, C., Diver, CJ., Foongchomcheay, A. (2016). “Systematic Review of Published Studies on Aquatic Exercise for Balance in Patients with Multiple Sclerosis, Parkinson’s Disease, and Hemiplegia.” Hong Kong Physiother J. 35(12-20). https://www.ncbi.nlm.nih.gov/pubmed/30931029.
5. “Multiple Sclerosis.” (2019). Mayo Clinic, Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269.