b' Increased nerve connectivity: ExerciseActivity Guidelines for Adults with Multiple promotes the formation and strengthening ofSclerosis developed for adults ages 18 to 64 nerve cell connections, enhancing communicationwith mild to moderate disability, recommend between different brain regions and potentiallyatleast30minutesofmoderate-intensity leading to improved cognitive performance. aerobic exercise twice per week and strength Adapting exercises to living with MS training for major muscle groups twice per week. When starting a program, you will need A variety of exercises can be benecial forto gradually increase duration, intensity, and people living with MS. However, adaptationsfrequencytowardmeetingtheguideline are often necessary depending on individualrecommendations. This progression of your abilities and symptoms:exercise program is where consultation withAerobic exercise: Activities such as walk- a physical therapist or exercise specialist is ing, swimming, and cycling can improve car- critical. diovasculartness,fatigue,andmood,Challenges and considerationspotentially affecting cognitive function. Despite the benets, people living with MSStrength training: Progressive strength train- face barriers to physical activity, including ing using weights, resistance bands, or yourfatigue,MS-relatedimpairments(suchas ownbodyweightcanimprovemuscleweakness or spasticity), time and nancial strength and endurance, combating muscleconstraints, and insufficient social support. weakness and fatigue linked to MS.Individualized exercise programs, developedMind-body practices: Yoga and Tai Chi areduring a consultation with a healthcare provider low-impactoptionsthatcombinephysicaland a physical therapist, are an essential rst postures, breathing techniques, and meditation,step to address specic needs and limitations. improving exibility, balance and strength, andIdentifying your goals for a PA or exercise program, reducing emotional stress and depression,as well as working with your healthcare team, which can positively inuence cognition. will facilitate greater success in following throughBalance exercises: Individualized exerciseswith your program long term. In addition, for balance are essential for safety and efficiencyregular check-ins allow you to modify your of movement, and exibility, such as stretching,goals and programs as needed.are crucial for people with MS to improvePhysical activity and exercise training represent coordination and range of motion. a powerful nonpharmacological approach toFlexibility exercises: Range of motion andimproveoverallwell-beinganddecrease stretching exercises are crucial to improve orcognitive decline in people with MS. Under-maintain optimal exibility for movementstanding the possible mechanisms underlying and prevention of musculoskeletal injury. these benets provides a strong rationale forAquatic therapy: Exercising in water offersintegrating exercise into comprehensive MS a low-impact environment that reduces themanagement plans. Continued research is risk of falls and provides gentle resistance,essential to further delineate optimal physical making it suitable for individuals with mobilityactivity and exercise protocols and address barriers to adherence. Further research will challenges. allow us to better personalize interventions It is benecial to work with your healthcarethatmaximizethepotentialofPAfor team when starting or progressing your PAimproving cognitive function and quality of and exercise program. The Canadian Physicallife in people living with MS. msfocusmagazine.org 15 msfocusmagazine.org'