b'of one person treated with natalizumab everyquality of life in people with MS. Five types of four weeks and those with a single physician- physical exercise were ranked: aerobic exercise indicated dosing change from every four to(treadmill, cycling, walking), resistance training everysixweeksafteratleastoneyearof(strength), combined aerobic with resistance, every-four-weeks treatment. The pairs weresensorimotor (coordination and balance), and observed for two years and no statisticallymind-body exercises (postural control and signicant differences were found betweenbreathing). Thestudiescombinedtohave the matched pairs. The research was funded2,428 participants, 76 percent were women, in part by Biogen, maker of Tysabri (natalizumab).and the average age of the participants was This study was published in Therapeutic45. Sensorimotor training was the best exercise Advances in Neurological Disorders.for mild disease and aerobic exercise for Dr. ThrowerTysabri (natalizumab) is one ofsevere disease for total health-related quality our most effective therapies for managingoflife. Aerobicandmind-bodyexercises relapsing forms of MS. In general, the drug isappeared to improve physical and mental well-tolerated, however, there is a risk ofhealth-related quality of life. This article was progressive multifocal leukoencephalopathy.published in the Annals of Physical and This risk is determined by a persons JCVRehabilitation Medicine. antibody index, any prior use of immuno- Dr. ThrowerWe know exercise is good for suppressant drugs and length of time onus all, including those in the MS community. therapy. In recent years, there has been greatOne of the more common questions I hear interestingivingtheinfusioneverysixis, Whats the best exercise for a person with weeks rather than every four weeks. StudiesMS? Ive traditionally advised that the best of extended interval dosing hoped to answerexercise is whatever you have access to and two questions: Is EID as effective as standardwill stick with. I think that still holds true, but dosinginmanagingMS?Also,doesEIDthis study shows that some specic forms of lower the risk of PML in patients who mayexercise may yield bigger improvements in have risk factors? This study, when combinedquality of life for those living with MS. After with real world experience, strongly suggestsreviewing numerous studies, these researchers that an every-six-week dosing of Tysabri isfound that sensorimotor exercises seemed to just as effective as every four weeks. Earliergive the biggest benet. So, what is sensorimotor studies have suggested that EID also lowerstraining? Sensorimotor training emphasizes theriskofPMLsignicantly.Moredatapostural control and progressive challenges should be coming soon. to the sensorimotor system. Yoga and Pilates could be considered forms of sensorimotor Study nds exercise yieldstraining. Standing or sitting with your eyes outcomes specic to type of MSclosed so that core muscles and position receptors are engaged would be a form of The authors of this network meta-analysissensorimotor training. If youre not sure what reviewed 45 randomized-controlled trials toyour specic exercise plan should look like, determine which type of physical exercise hasconsider having a physical therapist help you the greatest positive effect on health-relateddesign a regimen thats best for you. 55 msfocusmagazine.org'