A RESOURCE TO HELP ADULTS LIVING WITH MULTIPLE SCLEROSIS (MS) MEET THE CANADIAN PHYSICAL ACTIVITY GUIDELINES

MS Get Fit TOOLKIT

Keep reading for practical strategies and how you can start seeing benefits.

GUIDELINES AT Aglance

For important fitness benefits, adults with multiple sclerosis who have mild or moderate disability need at least:

•30minutesofaerobicactivity,2timesper week,AND

•Strength-trainingexercisesformajormuscle groups,2timesperweek

YOURability:Dowhatyoucantoworktowardsmeetingtheguidelines

YOURway:Pickmoderateintensityactivitiesthatfeelgoodandthatyouenjoy

WHO CAN BENEFIT?Ifyouarebetweentheagesof18and64andhavemildtomoderatedisabilityresultingfromrelapsingorprogressiveformsofMS,theseguidelinesareforyou.

“Physicalactivityhasalwaysprovidedmewithtimetothinkaboutthedayaheadbecausethemotionsarerepetitive,whetheritberunning,swimmingorrolling.Itgivesmeafeelingofwell-being.”--Samantha,relapsing-remittingMS,

diagnosedin1989

Here’s what to aim for:How hard?• Aerobicactivitiesshouldbemoderateinintensity;you shouldbeabletotalk–butnotsing!• Aimtodo2setsofstrengthexercisesforeachmajor musclegroup,with10-15repititionsperset.• Strength-trainingactivitiesshouldbedifficultenough thatyoucanbarelyfinishthesecondset.• Majormusclegroupsincludearms,legs,chest,back, buttocksandcore(abdominals).

How much rest?• It’sfinetodoaerobicandstrengtheningactivitieson thesameday.• Avoidstrength-trainingthesamemusclegroup(such aslegsorabdominals)twodaysinarow–yourbody needsabreakinbetweensessions.

BENEFITS OF PHYSICAL ACTIVITY

Inthepast,peoplewithMSweretoldtheyshouldn’tbephysicallyactive.

FACT:Nowweknowthatbeingactivehaspowerfulbenefits.Researchshowsthatfollowingtheguidelinesshouldimproveaerobicfitnessandstrength.Meetingtheguidelinesmayalsoreducefatigue,improvemobilityandenhanceyourhealthrelatedtoqualityoflife.

“Physicalactivityhashadahugeimpactonmyoverallenergylevels.Theweighttraininghashelpedalotwitheverydayactivities--suchastransfers,gettingoutofbed,andreachingforhard-to-getobjects.Thegymisalsoagreatplacetomeetandtalktopeople.”--Shawn,primary-progressiveMS

diagnosedin2006

“TheimportanceofexerciseandregularphysicalactivityCANNOTbeunderstated.Itcanmeanthedifferencebetweenfunctionanddysfunction,abilityanddisability,wellnessandillness,improvementanddecline.”

--Dr.TaniaR.Bruno,SpecialistPhysicianinPhysicalMedicineandRehabilitation

“Thereisnoscientificevidencethatfollowingtheguidelineswillresultinrelapseofmultiplesclerosissymptomsorworsenfatigueorhealthrelatedqualityoflife.”

--Dr.AmyLatimer,Physicalactivityanddisabilityresearcher

“WhenIfirststartedonthemodifiedellipticaltrainer,Icouldonlydo15minuteswithoutabreak,evenatlowerresistancelevels.NowIdo45minutes.”

--Ali,relapsing-remittingMS,diagnosedin2000

ACTIVITY EXAMPLESMS affects everyone differently. Try to find a mix of moderate-intensity activities that suit your abilities and lifestyle. Some examples are provided below.

If you walk independently or with a mobility aid, give these activities a try:

Aerobic•Walkorbike•Dance•Swimorjoinanaquafitnessclass•Playateamsportoranactivegamewithyour familyorfriends

Strength training•Liftweights(freeweightsormachines)•Useresistancebands•Useyourbodyweight.Doadaptedpush-ups, sit-ups,squats

If you use a manual or power wheelchair, give these activities a try:

Aerobic•Cyclewithahandcycleoronastationarybike•Wheel•Swimorjoinanaquafitnessclass•Playasportoranactivevideogame•Dance

Strength training•Liftweights(freeweightsormachines)•Useresistancebands

FOR ADDED BENEFITTaiChi,yoga,pilatesandstretchingaregreatactivitiestodoinadditiontothephysicalactivitiesyoudothemeetguidelines.Theycanbuildflexibility,balance,andbodyawareness.

The challenges of MS are real. Becoming and staying active can be challenging too. Here are some ways to overcome possible barriers.

I experience MS-related fatigue• Startslowly.Physicalactivitycanbetiringatfirst,butit willenergizeyouinthelongrun.• Restafterward.Theideaistoworkyourmusclesuntil theyarealittlefatigued.Thenletyourbodyrestandget strongagain.• Believeyoucandoit.Studiesshowthatthosewitha positiveattitudedofindwaystoexercise.

I have chronic pain• There’saway!Exercisesandequipmentcanbeadapted tofityourneeds.• Trydifferentactivities;findwhatworksforyouonthat day.

I have little access to a fitness centre• Makephysicalactivitypartofdailylife.• Usephysicalactivitytogetfromplacetoplace.• Tryaexercisevideoathome.•Walkorwheelaroundyourneighbourhood.

I need more support or information• Getaphysicalactivitybuddy.• Joinanadaptedsportsteaminyourcommunity.• Findalocalwalkingclub.• ConnectwithothersonFacebookandTwittertodiscuss physicalactivity.• Useresources:MSSocietyofCanada.

BE ACTIVE … SAFELYImportant tips to avoid injury•Progressatyourownpace. Youareaimingforalittlemuscle sorenessandfatigue,notintense painorexhaustion.

•Askahealthprofessionalsuch asadoctor,physiotherapist,or qualifiedexerciseprofessionalfor activitysuggestions

Avoid over-heating by:• Beactiveindoorsonhot,humiddays.• Drinklotsofcoolwater.• Keepaspraybottleofwaternearby, tocoolyourselfdownregularly.• Considerdoingpool-basedactivities.• Monitorhowyouarefeeling.Finda spottocooloffifyouaregettingtoo warm.

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Canadian Physical Activity Guidelines

FOR

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Preamble

Guidelines

www.csep.ca/guidelines© Canadian Society for Exercise Physiology, 2012. All rights reserved.

Now you’re ready to make an action plan.

Why have goals?Studies show that people who set challenging but achievable goals are more likely to be active.

“TRY. There is so much emphasis on what a person cannot do; focus on what you can do. Keeping a journal or log of how much activity you are getting is a great way to track your progress and to help commit to any goals you may have set.”

-- Ravin Persad, Kinesiologist and CSEP

Certified Exercise Physiologist

How to set exercise goals 1) Establish what you can do now. Example: Ride a stationary bike for 10 minutes, once a week.2) Set a goal for this week. Example: Ride a stationary bike for 10 minutes, with a little resistance, twice a week. 3) Set a goal for this month: Example: Add 5 minutes to my stationary bike ride each week. 4) Check in at the end of each week to see how you are doing. Did you reach your goal? Adjust your goal so it is challenging but doable.

Create a goal setting sheet. Write down: 1) What can you do right now?

2) What your goal is for this week?

3) What your goal is for this month?

Be flexibleLife is unpredictable. You may need to modify your goals to accommodate symptoms or unexpected events.

Keepin’ it realTips to achieve optimistic, realistic goals:Be steady: You don’t always have to improve; maintaining your level of physical fitness can be a goal.Share your goals: Tell someone what you are aiming for, and find a buddy to exercise with.Be aware of your body: Note how you’re feeling and do a little if you can’t do a lot.Take note of your success: Track your progress on your calendar or using an app on your smartphone.

YOUR ability

YOUR way MS Get Fit TOOLKIT

Include in your plan What activity you are going to do, Where you’ll do physical activity, when you’ll do it, for HOW Long, and the Intensity Level you are aiming for. The Canadian Physical Activity Guidelines recommend activities performed at a moderate intensity.

Making an Action Plan

Sample Action Plan This is an action plan that meets the guidelines.

Back-up Plan Things may get in the way of your physical activity plan. Be flexible and adjust the plan. There’s always a way! Think about the unexpected events that might pop up in your life. Have a back up plan now for the days life throws you a curve.

How to make your plan “sticky” Need help actually sticking to your action plan? Here are three ways to make sure you keep going:

1) Use action cues. Cues are triggers for a planned behaviour. For instance, if you are planning to do strength training later while watching TV, place the resistance band beside the TV, so it’s right there.

2) Focus on the first stage of getting ready. If you’ve set your alarm clock and planned a morning activity, but you’re losing motivation because of all that’s involved, just focus on dressing appropriately and getting out the door … the rest will fall into place!

3) Make physical activity plans with others. They will help keep you on track.

Sun Mon Tues Wed Thurs Fri SatActivity

Where:

Howlong:

When:

Intensity:

Stationary bike, then sit-ups, push-ups and squatsCommunityCentre11 am

Moderate

30 min. bikeand 20 min. strength

Off ResistanceBand

Home

8 am

Moderate

10 min. legs, 10 min. arms

Off Swim

CommunityPool5:30 pm

Moderate

30 min.

Off Off

Unexpected event Back-Up planFatigue/symptoms Change workout from Saturday to Sunday

Bad weather Use treadmill instead of walking outdoors

Working late Do 10 min. instead of 20 min.