Rehabilitation Assoc. Of Long Island
Review of: Impact of Exercise on Innate Immunity in Multiple Sclerosis Progression and Symptomatology in Frontiers of Physiology, June 2016
Multiple sclerosis (MS) is a disease that can cause severe disability in the people it afflicts.
It mainly affects young adults from 20 – 40 years of age. It is the most common cause of non-traumatic neurologic disability in that age group. In today’s post RALI will review a recent article that was published in Frontiers of Physiology in June 2016. This article discussed the mechanisms that cause MS and how exercise can decrease them.
In MS, a part of a person’s immune system called T cells attacks the central nervous system (CNS). These cells attack the myelin making cells of the brain and the spinal cord nerves. Myelin sheaths covers the axons of nerve cells.
The axons are like wires that connect the different parts of the nervous system. Myelin works like an insulator on the axon wires and helps them to send information faster and more efficiently. The attacking cells destroy the myelin insulation on the nerves and short circiut the signals they are sending to the muscles, brain and organs. This results in weakness and impaired control of movement, sensation, vision, bladder function and thinking. These immune cells cause inflammation in the CNS.
MS is treated with medications called immunomodulators; such as Avonex, Gilenya and Tysabri. These are some of the medications that help to decrease the immune cells attack on the body. They have limitation, as their effectiveness in preventing progression of the disease ranges from 40-60% reduction of new lesions and decreased function. Many of them have side effects and complications. A non-pharmaceutical adjunct to medication is exercise therapy. It is complimentary to medication treatment.
Many studies have shown that exercise decreases inflammation in the brain and the spinal cord. Recent studies have shown that exercise decreases inflammation by reducing the activity of receptors on immune cells that cause inflammation. These areas are called Toll Receptors and they are found on the surface membranes of the immune cells that attack the nerves of the brain and spinal cord.
Resistance and aerobic training have been shown to have an anti-inflammatory affect by decreasing mediators of inflammation.
Regular exercise can decrease chronic inflammation. In MS evidence shows that regular exercise can induce an anti-inflammatory effect and may be beneficial in the decrease of MS progression.
A study showed that MS patients who recieved combined endurance and resistance exercise training for 8 weeks had significantly decreased mediators of inflammation called IL-17 and INF. IL-17 is one of the most important promotors of inflammation and a cause of worsening in MS. Another study showed that following 30 minutes of moderate aerobic exercise IFN levels were significantly decreased. Overall these findings show that exercise training may have an anti-inflammatory effect in MS patients. Exercise has also been shown to improve MS patients’ strength, mobility, and balance. Exercise can also help decrease depression and fatigue. Exercise is neuro protective and improves memory and problem solving. Most of the studies that showed improvement used a combination of aerobic training using cycling, treadmill or arm ergometer. This was combined with strength and balance training 2-3 x a week.
Although there is no cure for MS, medications can help to decrease the frequency and severity of relapses and long term disability.However, medications have limitations and exercise has been found to be a good compliment to medications because it can assist in decreasing inflammation in the CNS by decreasing the attack of the immune system on the brain and spinal cord.
At RALI we have developed specific exercise programs for patients with MS that combine techniques that have been shown to decrease the effects of MS and improve function.
RALI for Health