Problems that can arise during exercise in a patient with multiple sclerosis
(1) decrease in vision (Uthoff's phenomenon)
(2) muscle weakness
(3) excessive fatigue
(4) falls (associated with impaired balance)
(5) loss of consciousness (secondary to excessive heat)
Risk factors for exercise problems:
(1) moderate or severe MS
(2) heat sensitivity
(3) autonomic dysfunction
(4) severe deconditioning
Some recommendations:
(1) The patient should not exercise alone.
(2) Exposure to heat or sun should be monitored.
(3) The person should avoid situations where a sudden onset of symptoms could result in injury.
(4) A patient with anxiety or depression may require additional emotional support, at least initially.
(5) The exercise regimen may need to be altered with disease progression.
